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Journal of Cardiovascular Magnetic Resonance
Published in: Journal of Cardiovascular Magnetic Resonance 1/2010

Open Access 01-12-2010 | Research

Hemodynamic predictors of aortic dilatation in bicuspid aortic valve by velocity-encoded cardiovascular magnetic resonance

Authors: P Martijn den Reijer, Denver Sallee III, Petra van der Velden, Eline R Zaaijer, W James Parks, Senthil Ramamurthy, Trevor Q Robbie, Giorgina Donati, Carey Lamphier, Rudolf P Beekman, Marijn E Brummer

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2010

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Abstract

Background

Congenital Bicuspid Aortic Valve (BAV) is a significant risk factor for serious complications including valve dysfunction, aortic dilatation, dissection, and sudden death. Clinical tools for identification and monitoring of BAV patients at high risk for development of aortic dilatation, an early complication, are not available.

Methods

This paper reports an investigation in 18 pediatric BAV patients and 10 normal controls of links between abnormal blood flow patterns in the ascending aorta and aortic dilatation using velocity-encoded cardiovascular magnetic resonance. Blood flow patterns were quantitatively expressed in the angle between systolic left ventricular outflow and the aortic root channel axis, and also correlated with known biochemical markers of vessel wall disease.

Results

The data confirm larger ascending aortas in BAV patients than in controls, and show more angled LV outflow in BAV (17.54 ± 0.87 degrees) than controls (10.01 ± 1.29) (p = 0.01). Significant correlation of systolic LV outflow jet angles with dilatation was found at different levels of the aorta in BAV patients STJ: r = 0.386 (N = 18, p = 0.048), AAO: r = 0.536 (N = 18, p = 0.022), and stronger correlation was found with patients and controls combined into one population: SOV: r = 0.405 (N = 28, p = 0.033), STJ: r = 0.562 (N = 28, p = 0.002), and AAO r = 0.645 (N = 28, p < 0.001). Dilatation and the flow jet angle were also found to correlate with plasma levels of matrix metallo-proteinase 2.

Conclusions

The results of this study provide new insights into the pathophysiological processes underlying aortic dilatation in BAV patients. These results show a possible path towards the development of clinical risk stratification protocols in order to reduce morbidity and mortality for this common congenital heart defect.
Appendix
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Metadata
Title
Hemodynamic predictors of aortic dilatation in bicuspid aortic valve by velocity-encoded cardiovascular magnetic resonance
Authors
P Martijn den Reijer
Denver Sallee III
Petra van der Velden
Eline R Zaaijer
W James Parks
Senthil Ramamurthy
Trevor Q Robbie
Giorgina Donati
Carey Lamphier
Rudolf P Beekman
Marijn E Brummer
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Journal of Cardiovascular Magnetic Resonance / Issue 1/2010
Electronic ISSN: 1532-429X
DOI
https://doi.org/10.1186/1532-429X-12-4

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