Artery Research

Volume 20, Issue C, December 2017, Pages 53 - 54

3.3 ASSESSMENT OF AORTIC MORPHOLOGY IN A BICUSPID AORTIC VALVE POPULATION

Authors
Froso Sophocleous1, Benedetta Biffi2, Elena Giulia Milano3, 4, Cha Rajakaruna3, 4, Massimo Caputo3, 4, Costanza Emanueli1, 5, Chiara Bucciarelli-Ducci3, 4, Tom Gaunt1, Silvia Schievano2, Giovanni Biglino1
1Bristol Medical School, University of Bristol, UK
2Institute of Cardiovascular Science, University College London, UK
3University of Bristol, UK
4University Hospitals Bristol, UK
5Imperial College London, UK
Available Online 6 December 2017.
DOI
10.1016/j.artres.2017.10.033How to use a DOI?
Abstract

Background: Bicuspid aortic valve (BAV) is a congenital heart disease associated with aortic wall abnormalities and co-existing with other congenital defects (e.g. aortic coarctation). This study aimed to explore aortic shape features in a BAV population, identifying sub-groups with different aortic morphologies.

Methods: Single-centre retrospective study. Patients with an MRI scan and native BAV diagnosis between 2011 and 16 were studied (n = 525); those with a 3D MRI dataset were included for shape analysis (n = 108, 64% males, 38 ± 16.5 years). MRI-derived 3D aortic reconstructions were analysed using a statistical shape modelling framework [1]. A mean aortic shape (‘template’) was computed and shape deformations were correlated with demographic, volumetric and functional data.

Results: Aortic coarctation (n = 71) was significantly associated with a more gothic arch (p = 0.02), more tubular ascending aorta and descending aorta dilation (p < 0.001). Also, smaller aortic size in patients with coarctation was associated with the younger age of this group (33 ± 13 vs. 47 ± 19, p < 0.001), given the overall relationship between aortic size and age (p < 0.001). Aortic stenosis (n = 30) was also associated with gothic arch (p = 0.01), and dilated ascending aorta but with no aortic root dilation (p = 0.02).

On multivariate regression analysis, gothic arch was indeed associated with coarctation and stenosis, and also with non-coronary valve fusion pattern (p = 0.03). Patients with aortic regurgitation tended to have larger aortas (p = 0.005).

Conclusion: The presence of aortic coarctation and stenosis may influence the amount of dilation and the overall arch architecture in BAV patients. Patients with BAV present profoundly different morphological phenotypes depending on the presence/absence of aortic coarctation (Fig. 1).

Figure 1

Shape features of coarctation (CoA) vs no CoA in BAY population. A) The ‘template’ (or average shape) for patients with CoA on the left, and patients without CoA on the right. B) Patients with CoA have tubular ascending aortas (left), while patients without CoA tend to have increased ascending aortic dilation (right). C) Patients with CoA have more a gothic arch (left), whereas patients without CoA have a rounder arch (right).

Open Access
This is an open access article distributed under the CC BY-NC license.

References

1.JL Bruse et al., “A statistical shape modelling framework to extract 3D shape biomarkers from medical imaging data: assessing arch morphology of repaired coarctation of the aorta.”, BMC Med Imaging, Vol. 16, No. 1, 2016, pp. 40.
Journal
Artery Research
Volume-Issue
20 - C
Pages
53 - 54
Publication Date
2017/12/06
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2017.10.033How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

TY  - JOUR
AU  - Froso Sophocleous
AU  - Benedetta Biffi
AU  - Elena Giulia Milano
AU  - Cha Rajakaruna
AU  - Massimo Caputo
AU  - Costanza Emanueli
AU  - Chiara Bucciarelli-Ducci
AU  - Tom Gaunt
AU  - Silvia Schievano
AU  - Giovanni Biglino
PY  - 2017
DA  - 2017/12/06
TI  - 3.3 ASSESSMENT OF AORTIC MORPHOLOGY IN A BICUSPID AORTIC VALVE POPULATION
JO  - Artery Research
SP  - 53
EP  - 54
VL  - 20
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2017.10.033
DO  - 10.1016/j.artres.2017.10.033
ID  - Sophocleous2017
ER  -