Predictors of valve degeneration in 223 consecutive patients with bicuspid aortic valve: A single-center prospective study - 05/01/18
, A. Touil 1, N. Resseguier 2, E. Faure 3, M. Sumian 1, A.S. Simoni 1, G. Habib 4, F. Collart 4, S. Zaffran 3, J.F. Avierinos 3, 4, 5, 6Bienvenue sur EM-consulte, la référence des professionnels de santé.
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Résumé |
Background |
The physiopathology of bicuspid aortic valve (BAV) degeneration remains unknown. Altered hemodynamic environment could favor valve degeneration.
Aim |
(1) To compare clinical and echocardiographic data of normally functioning and dysfunctional BAV; and (2) to correlate BAV phenotype to valve function.
Methods |
Consecutive patients with normally functioning (NF-BAV) or dysfunctional BAV (D-BAV) were prospectively included. Sievers’ classification was used to compare BAV regarding valve function.
Results |
A total of 223 patients with BAV were prospectively included. Mean age was 52.9±16.5 years with a male predominance (n=168, 75.3%). Twenty-four patients had NF-BAV and 199 patients had D-BAV. One hundred and seventy-eight patients (82.4%) had a Sievers’ type 1 BAV, mainly with an intercoronary leaflet fusion (n=155, 87.1%). BAV aortopathy was found in 86 patients (38.5%). By multivariable analysis, age>50years (5.5 [2.2–17.4], P=0.0006), male gender (3.4 [1.2–9.3], P=0.01) and the presence of a raphe (3.6 [1.2–9.9], P=0.01) were significantly associated with BAV dysfunction. Among D-BAV, 68 patients (34%) had AS and 91 patients (45%) had AR. Multivariate analysis revealed that a higher age (1.9 [1.85–1.94], P<0.001) and dyslipidemia (3.3 [1.22–8.22], P<0.001) were the independent factors associated with AS (Figure 1).
Conclusions |
Commissural fusion of aortic cusps is associated with BAV dysfunction. By altering aortic blood flow and stiffening fused leaflet, the raphe could accelerate valve degeneration. These results suggested the emerging role of mechanobiology in BAV degeneration.
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Vol 10 - N° 1
P. 72-73 - janvier 2018 Retour au numéro
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