Predictors of Ascending Aorta Enlargement and Valvular Dysfunction Progression in Patients with Bicuspid Aortic Valve

Bicuspid aortic valve (BAV) patients are at high risk of developing progressive aortic valve dysfunction and ascending aorta dilation. However, the progression of the disease is not well defined. We aimed to assess mid-long-term aorta dilation and valve dysfunction progression and their predictors....

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Autores principales:	Angela Lopez, Ilaria Dentamaro, Laura Galian, Francisco Calvo, Josep M. Alegret, Violeta Sanchez, Rodolfo Citro, Antonella Moreo, Fabio Chirillo, Paolo Colonna, María Celeste Carrero, Eduardo Bossone, Sergio Moral, Augusto Sao-Aviles, Laura Gutiérrez, Gisela Teixido-Tura, Jose Rodríguez-Palomares, Arturo Evangelista
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	bicuspid aortic valve aneurysm aortic stenosis aortic regurgitation Medicine R
Acceso en línea:	https://doaj.org/article/c6019984260c44b88cbc304d5f396860
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spelling	oai:doaj.org-article:c6019984260c44b88cbc304d5f3968602021-11-25T18:01:04ZPredictors of Ascending Aorta Enlargement and Valvular Dysfunction Progression in Patients with Bicuspid Aortic Valve10.3390/jcm102252642077-0383https://doaj.org/article/c6019984260c44b88cbc304d5f3968602021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5264https://doaj.org/toc/2077-0383Bicuspid aortic valve (BAV) patients are at high risk of developing progressive aortic valve dysfunction and ascending aorta dilation. However, the progression of the disease is not well defined. We aimed to assess mid-long-term aorta dilation and valve dysfunction progression and their predictors. Patients were referred from cardiac outpatient clinics to the echocardiographic laboratories of 10 tertiary hospitals and followed clinically and by echocardiography for >5 years. Seven hundred and eighteen patients with BAV (median age 47.8 years [IQR 33–62], 69.2% male) were recruited. BAV without raphe was observed in 11.3%. After a median follow-up of 7.2 years [IQR5–8], mean aortic root growth rate was 0.23 ± 0.15 mm/year. On multivariate analysis, rapid aortic root dilation (>0.35 mm/year) was associated with male sex, hypertension, presence of raphe and aortic regurgitation. Annual ascending aorta growth rate was 0.43 ± 0.32 mm/year. Rapid ascending aorta dilation was related only to hypertension. Variables associated with aortic stenosis and regurgitation progression, adjusted by follow-up time, were presence of raphe, hypertension and dyslipidemia and basal valvular dysfunction, respectively. Intrinsic BAV characteristics and cardiovascular risk factors were associated with aorta dilation and valvular dysfunction progression, taking into account the inherent limitations of our study-design. Strict and early control of cardiovascular risk factors is mandatory in BAV patients.Angela LopezIlaria DentamaroLaura GalianFrancisco CalvoJosep M. AlegretVioleta SanchezRodolfo CitroAntonella MoreoFabio ChirilloPaolo ColonnaMaría Celeste CarreroEduardo BossoneSergio MoralAugusto Sao-AvilesLaura GutiérrezGisela Teixido-TuraJose Rodríguez-PalomaresArturo EvangelistaMDPI AGarticlebicuspid aortic valveaneurysmaortic stenosisaortic regurgitationMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5264, p 5264 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	bicuspid aortic valve aneurysm aortic stenosis aortic regurgitation Medicine R
spellingShingle	bicuspid aortic valve aneurysm aortic stenosis aortic regurgitation Medicine R Angela Lopez Ilaria Dentamaro Laura Galian Francisco Calvo Josep M. Alegret Violeta Sanchez Rodolfo Citro Antonella Moreo Fabio Chirillo Paolo Colonna María Celeste Carrero Eduardo Bossone Sergio Moral Augusto Sao-Aviles Laura Gutiérrez Gisela Teixido-Tura Jose Rodríguez-Palomares Arturo Evangelista Predictors of Ascending Aorta Enlargement and Valvular Dysfunction Progression in Patients with Bicuspid Aortic Valve
description	Bicuspid aortic valve (BAV) patients are at high risk of developing progressive aortic valve dysfunction and ascending aorta dilation. However, the progression of the disease is not well defined. We aimed to assess mid-long-term aorta dilation and valve dysfunction progression and their predictors. Patients were referred from cardiac outpatient clinics to the echocardiographic laboratories of 10 tertiary hospitals and followed clinically and by echocardiography for >5 years. Seven hundred and eighteen patients with BAV (median age 47.8 years [IQR 33–62], 69.2% male) were recruited. BAV without raphe was observed in 11.3%. After a median follow-up of 7.2 years [IQR5–8], mean aortic root growth rate was 0.23 ± 0.15 mm/year. On multivariate analysis, rapid aortic root dilation (>0.35 mm/year) was associated with male sex, hypertension, presence of raphe and aortic regurgitation. Annual ascending aorta growth rate was 0.43 ± 0.32 mm/year. Rapid ascending aorta dilation was related only to hypertension. Variables associated with aortic stenosis and regurgitation progression, adjusted by follow-up time, were presence of raphe, hypertension and dyslipidemia and basal valvular dysfunction, respectively. Intrinsic BAV characteristics and cardiovascular risk factors were associated with aorta dilation and valvular dysfunction progression, taking into account the inherent limitations of our study-design. Strict and early control of cardiovascular risk factors is mandatory in BAV patients.
format	article
author	Angela Lopez Ilaria Dentamaro Laura Galian Francisco Calvo Josep M. Alegret Violeta Sanchez Rodolfo Citro Antonella Moreo Fabio Chirillo Paolo Colonna María Celeste Carrero Eduardo Bossone Sergio Moral Augusto Sao-Aviles Laura Gutiérrez Gisela Teixido-Tura Jose Rodríguez-Palomares Arturo Evangelista
author_facet	Angela Lopez Ilaria Dentamaro Laura Galian Francisco Calvo Josep M. Alegret Violeta Sanchez Rodolfo Citro Antonella Moreo Fabio Chirillo Paolo Colonna María Celeste Carrero Eduardo Bossone Sergio Moral Augusto Sao-Aviles Laura Gutiérrez Gisela Teixido-Tura Jose Rodríguez-Palomares Arturo Evangelista
author_sort	Angela Lopez
title	Predictors of Ascending Aorta Enlargement and Valvular Dysfunction Progression in Patients with Bicuspid Aortic Valve
title_short	Predictors of Ascending Aorta Enlargement and Valvular Dysfunction Progression in Patients with Bicuspid Aortic Valve
title_full	Predictors of Ascending Aorta Enlargement and Valvular Dysfunction Progression in Patients with Bicuspid Aortic Valve
title_fullStr	Predictors of Ascending Aorta Enlargement and Valvular Dysfunction Progression in Patients with Bicuspid Aortic Valve
title_full_unstemmed	Predictors of Ascending Aorta Enlargement and Valvular Dysfunction Progression in Patients with Bicuspid Aortic Valve
title_sort	predictors of ascending aorta enlargement and valvular dysfunction progression in patients with bicuspid aortic valve
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/c6019984260c44b88cbc304d5f396860
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Predictors of Ascending Aorta Enlargement and Valvular Dysfunction Progression in Patients with Bicuspid Aortic Valve

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