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Aortic wall shear stress in bicuspid aortic valve disease—10-year follow-up

BACKGROUND: Bicuspid aortic valve (BAV) disease leads to deviant helical flow patterns especially in the mid-ascending aorta (AAo), potentially causing wall alterations such as aortic dilation and dissection. Among others, wall shear stress (WSS) could contribute to the prediction of long-term outco...

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Autores principales: Hanigk, Michael, Burgstaller, Elisabeth, Latus, Heiner, Shehu, Nerejda, Zimmermann, Judith, Martinoff, Stefan, Hennemuth, Anja, Ewert, Peter, Stern, Heiko, Meierhofer, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9971286/
https://www.ncbi.nlm.nih.gov/pubmed/36864959
http://dx.doi.org/10.21037/cdt-22-477
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author Hanigk, Michael
Burgstaller, Elisabeth
Latus, Heiner
Shehu, Nerejda
Zimmermann, Judith
Martinoff, Stefan
Hennemuth, Anja
Ewert, Peter
Stern, Heiko
Meierhofer, Christian
author_facet Hanigk, Michael
Burgstaller, Elisabeth
Latus, Heiner
Shehu, Nerejda
Zimmermann, Judith
Martinoff, Stefan
Hennemuth, Anja
Ewert, Peter
Stern, Heiko
Meierhofer, Christian
author_sort Hanigk, Michael
collection PubMed
description BACKGROUND: Bicuspid aortic valve (BAV) disease leads to deviant helical flow patterns especially in the mid-ascending aorta (AAo), potentially causing wall alterations such as aortic dilation and dissection. Among others, wall shear stress (WSS) could contribute to the prediction of long-term outcome of patients with BAV. 4D flow in cardiovascular magnetic resonance (CMR) has been established as a valid method for flow visualization and WSS estimation. The aim of this study is to reevaluate flow patterns and WSS in patients with BAV 10 years after the initial evaluation. METHODS: Fifteen patients (median age 34.0 years) with BAV were re-evaluated 10 years after the initial study from 2008/2009 using 4D flow by CMR. Our particular patient cohort met the same inclusion criteria as in 2008/2009, all without enlargement of the aorta or valvular impairment at that time. Flow patterns, aortic diameters, WSS and distensibility were calculated in different aortic regions of interest (ROI) with dedicated software tools. RESULTS: Indexed aortic diameters in the descending aorta (DAo), but especially in the AAo did not change in the 10-year period. Median difference 0.05 cm/m(2) (95% CI: 0.01 to 0.22; P=0.06) for AAo and median difference −0.08 cm/m(2) (95% CI: −0.12 to 0.01; P=0.07) for DAo. WSS values were lower in 2018/2019 at all measured levels. Aortic distensibility decreased by median 25.6% in the AAo, while stiffness increased concordantly (median +23.6%). CONCLUSIONS: After a ten years’ follow-up of patients with isolated BAV disease, indexed aortic diameters did not change in this patient cohort. WSS was lower compared to values generated 10 years earlier. Possibly a drop of WSS in BAV could serve as a marker for a benign long-term course and implementation of more conservative treatment strategies.
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spelling pubmed-99712862023-03-01 Aortic wall shear stress in bicuspid aortic valve disease—10-year follow-up Hanigk, Michael Burgstaller, Elisabeth Latus, Heiner Shehu, Nerejda Zimmermann, Judith Martinoff, Stefan Hennemuth, Anja Ewert, Peter Stern, Heiko Meierhofer, Christian Cardiovasc Diagn Ther Original Article BACKGROUND: Bicuspid aortic valve (BAV) disease leads to deviant helical flow patterns especially in the mid-ascending aorta (AAo), potentially causing wall alterations such as aortic dilation and dissection. Among others, wall shear stress (WSS) could contribute to the prediction of long-term outcome of patients with BAV. 4D flow in cardiovascular magnetic resonance (CMR) has been established as a valid method for flow visualization and WSS estimation. The aim of this study is to reevaluate flow patterns and WSS in patients with BAV 10 years after the initial evaluation. METHODS: Fifteen patients (median age 34.0 years) with BAV were re-evaluated 10 years after the initial study from 2008/2009 using 4D flow by CMR. Our particular patient cohort met the same inclusion criteria as in 2008/2009, all without enlargement of the aorta or valvular impairment at that time. Flow patterns, aortic diameters, WSS and distensibility were calculated in different aortic regions of interest (ROI) with dedicated software tools. RESULTS: Indexed aortic diameters in the descending aorta (DAo), but especially in the AAo did not change in the 10-year period. Median difference 0.05 cm/m(2) (95% CI: 0.01 to 0.22; P=0.06) for AAo and median difference −0.08 cm/m(2) (95% CI: −0.12 to 0.01; P=0.07) for DAo. WSS values were lower in 2018/2019 at all measured levels. Aortic distensibility decreased by median 25.6% in the AAo, while stiffness increased concordantly (median +23.6%). CONCLUSIONS: After a ten years’ follow-up of patients with isolated BAV disease, indexed aortic diameters did not change in this patient cohort. WSS was lower compared to values generated 10 years earlier. Possibly a drop of WSS in BAV could serve as a marker for a benign long-term course and implementation of more conservative treatment strategies. AME Publishing Company 2023-02-10 2023-02-28 /pmc/articles/PMC9971286/ /pubmed/36864959 http://dx.doi.org/10.21037/cdt-22-477 Text en 2023 Cardiovascular Diagnosis and Therapy. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Hanigk, Michael
Burgstaller, Elisabeth
Latus, Heiner
Shehu, Nerejda
Zimmermann, Judith
Martinoff, Stefan
Hennemuth, Anja
Ewert, Peter
Stern, Heiko
Meierhofer, Christian
Aortic wall shear stress in bicuspid aortic valve disease—10-year follow-up
title Aortic wall shear stress in bicuspid aortic valve disease—10-year follow-up
title_full Aortic wall shear stress in bicuspid aortic valve disease—10-year follow-up
title_fullStr Aortic wall shear stress in bicuspid aortic valve disease—10-year follow-up
title_full_unstemmed Aortic wall shear stress in bicuspid aortic valve disease—10-year follow-up
title_short Aortic wall shear stress in bicuspid aortic valve disease—10-year follow-up
title_sort aortic wall shear stress in bicuspid aortic valve disease—10-year follow-up
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9971286/
https://www.ncbi.nlm.nih.gov/pubmed/36864959
http://dx.doi.org/10.21037/cdt-22-477
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