Aortic morphological variability in patients with bicuspid aortic valve and aortic coarctation
File(s)AORTIC M__ VARIABILITY_Supplementary Tables EJCTS BAVCoA-2.docx (31.26 KB) ezy339.pdf (1.9 MB)
Supporting information
Published version
Author(s)
Type
Journal Article
Abstract
OBJECTIVES: This study aimed to explore aortic morphology and the associations between morphological features and cardiovascular function in a population of patients with bicuspid aortic valve, while further assessing differences between patients with repaired coarctation, patients with unrepaired coarctation and patients without coarctation. METHODS: This is a single-centre retrospective study that included patients with available cardiovascular magnetic resonance imaging data and native bicuspid aortic valve diagnosis (n = 525). A statistical shape analysis was performed on patients with a 3-dimensional magnetic imaging resonance (MRI) dataset (n = 108), deriving 3-dimensional aortic reconstructions and computing a mean aortic shape (template) for the whole population as well as for the 3 subgroups of interest (no coarctation, repaired coarctation and unrepaired coarctation). Shape deformations (modes) were computed and correlated with demographic variables, 2-dimensional MRI measurements and volumetric and functional data. RESULTS: Overall, the results showed that patients with coarctation tended towards a more Gothic arch architecture, with decreased ascending and increased descending aorta diameters, with the unrepaired-aortic coarctation subgroup exhibiting more ascending aorta dilation. Careful assessment of patients with repaired coarctation only revealed that a more Gothic arch, increased descending aorta dimensions and ascending aorta dilation were associated with reduced ejection fraction (P ≤ 0.04), increased end-diastolic volume (P ≤ 0.04) and increased ventricular mass (P ≤ 0.02), with arch morphology distinguishing patients with and without recoarctation (P = 0.05). CONCLUSIONS: A statistical shape modelling framework was applied to a bicuspid aortic valve population revealing nuanced differences in arch morphology and demonstrating that morphological features, not immediately described by conventional measurements, can indicate those shape phenotypes associated with compromised function and thus possibly warranting closer follow-up.
Date Issued
2019-04-01
Date Acceptance
2018-09-06
Citation
European Journal of Cardio-Thoracic Surgery, 2019, 55 (4), pp.704-713
ISSN
1010-7940
Publisher
Oxford University Press (OUP)
Start Page
704
End Page
713
Journal / Book Title
European Journal of Cardio-Thoracic Surgery
Volume
55
Issue
4
Copyright Statement
© The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30380029
PII: 5149339
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Respiratory System
Surgery
Cardiovascular System & Cardiology
Congenital heart disease
Bicuspid aortic valve
Aortic coarctation
Aorta
Magnetic resonance imaging
Computational modelling
ARCH GEOMETRY
REPAIR
SHAPE
HYPERTENSION
DYSFUNCTION
MRI
Aorta
Aortic coarctation
Bicuspid aortic valve
Computational modelling
Congenital heart disease
Magnetic resonance imaging
Respiratory System
1102 Cardiorespiratory Medicine and Haematology
Publication Status
Published
Coverage Spatial
Germany
Date Publish Online
2018-10-30