Aortic Elongation in Bicuspid Aortic Valve with Aortic Stenosis Assessed by Thin-Slice Electrocardiogram-Gated Computed Tomography
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- Fujiwara Jumpei
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
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- Orii Makoto
- Department of Radiology, Iwate Medical University
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- Takagi Hidenobu
- Department of Radiology, Iwate Medical University
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- Chiba Takuya
- Center for Radiological Science, Iwate Medical University
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- Sasaki Tadashi
- Center for Radiological Science, Iwate Medical University
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- Tanaka Ryoichi
- Division of Dental Radiology, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University
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- Kin Hajime
- Department of Cardiovascular Surgery, Iwate Medical University
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- Morino Yoshihiro
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
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- Yoshioka Kunihiro
- Department of Radiology, Iwate Medical University
Abstract
<p>Bicuspid aortic valve (BAV) patients with aortic stenosis (AS) are known to develop dilatation of the ascending aorta at a younger age, but the morphology of the aorta in these patients is yet to be investigated. Thus, in this study, we aim to evaluate the aortic morphology of BAV patients with severe AS using thin-slice electrocardiogram (ECG) -gated computed tomography (CT) and identify the possible contributing effect of age.</p><p>In this retrospective study, 122 BAV and 154 tricuspid aortic valve (TAV) patients who received aortic valve replacement for severe AS were assessed by thin-slice ECG-gated CT and three-dimensional reconstruction. The morphology of the ascending aorta was also evaluated among BAV patients aged < 70 (n = 72) and ≥ 70 (n = 50) years old. As per our findings, BAV patients with severe AS had significantly greater diameter (P < 0.01), elongation (P < 0.01), and tortuosity (P = 0.03) of the ascending aorta; minimum aortic arch angle (P < 0.01); and significantly lower calcified plaque (P < 0.01) compared with those of TAV patients even after adjusting for background. Multiple regression analysis showed that standardized partial regression coefficients (β) of dilatation (0.5) and elongation (0.35) were higher among other measurements of aortic morphology for BAV patients. BAV patients with severe AS aged ≥ 70 years had significantly greater diameter (42.0 [37.2-46.1] mm versus 40.4 [35.2-44.2] mm, P = 0.049) and elongation (133.8 [123.5-147.3] mm versus 127.0 [111.0-140.0] mm, P = 0.01) of the ascending aorta than those aged < 70 years.</p><p>BAV patients with severe AS were determined to have greater dilatation and elongation of the ascending aorta. Moreover, BAV patients older than 70 years had greater diameter and elongation of the ascending aorta.</p>
Journal
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- International Heart Journal
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International Heart Journal 63 (2), 319-326, 2022-03-30
International Heart Journal Association