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Clinical insights into a tertiary care center cohort of patients with bicuspid aortic valve

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Abstract

Although bicuspid aortic valve (BAV) is one of the most common congenital heart diseases, clinical data associated with valve dysfunction are still limited. We evaluated clinical characteristics and echocardiography of French patients with BAV associated with leaking and stenosis degeneration. We initiated a prospective registry from 2014 to 2018 at a tertiary center. A total of 223 patients (168 males [75%], age 53 ± 17 years) were enrolled. Among these patients 83% had left–right coronary cusps fusion, 80% Sievers type 1 BAV and 49% showed aortic dilatation. Twenty-four patients (11%) had normal valve function, 66 patients (31%) had aortic stenosis (AS), 91 patients (41%) had aortic regurgitation (AR) and 40 patients (17%) had AR and AS. BAV phenotype did not predict neither AS nor AR (all p > 0.1). By multivariable analysis, age > 50 (41.6[10.3–248.2], p < 0.001) and presence of raphe/fusion (12.8[2.4–87.4], p < 0.001) were significantly associated with AS, whereas male gender was associated with AR (5[1.6–16.4], p = 0.005). In addition, leaking degeneration was observed at a much younger age than stenosis (44 ± 14 years vs. 66 ± 10 years, p < 0.01) and among patients with valve dysfunction younger age was independently associated with AR (1.9[1.85–1.94], p < 0.001). In this study we confirmed high prevalence of valve dysfunction at first diagnosis of BAV in a referred population. The degenerative process differs according to type of dysfunction and is mainly dependent on age and gender.

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Acknowledgements

We are grateful to Amélie Pinard and Emilie Faure for their assistance. We thank Marine Herbane for her pretty shema.

Funding

This research was supported by the “Institut National de la Santé et de la Recherche Médicale” and the “Fédération Française de Cardiologie” to S.Z. G.O. received fellowships from the “Fondation pour la Recherche Médicale”, the “Institut National de la Santé et de la Recherche Médicale”, and the “Fondation Lefoulon Delalande”. A.T. received the young researcher award from the “Société Française de Cardiologie” for this work.

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Authors and Affiliations

  1. Aix Marseille Univ, INSERM, Marseille Medical Genetics, U1251, 13005, Marseille, France

    Alexis Théron, Gwenaelle Collod-Beroud, Gaëlle Odelin, Stéphane Zaffran & Jean-François Avierinos

  2. Département de Chirurgie Cardiaque, Hôpital de la Timone, 13005, Marseille, France

    Alexis Théron, Anissa Touil, Anne-Sophie Simoni & Frédéric Collart

  3. Département de Cardiologie, AP-HM, Hôpital de la Timone, 13005, Marseille, France

    Anissa Touil, Giulia Norscini, Anne-Sophie Simoni, Gilbert Habib & Jean-François Avierinos

  4. EA 3279, Faculté de Médecine, 27 Bd Jean Moulin, 13005, Marseille, France

    Noémie Résseguier

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  1. Alexis Théron
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  2. Anissa Touil
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  4. Gwenaelle Collod-Beroud
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Correspondence to Stéphane Zaffran or Jean-François Avierinos.

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Théron, A., Touil, A., Résseguier, N. et al. Clinical insights into a tertiary care center cohort of patients with bicuspid aortic valve. Int J Cardiovasc Imaging 38, 51–59 (2022). https://doi.org/10.1007/s10554-021-02366-1

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