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Association of aortic distensibility and left ventricular function in patients with stenotic bicuspid aortic valve and preserved ejection fraction: a CMR study

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Abstract

To determine the relationship between aortic distensibility and left ventricular (LV) remodeling, myocardial strain and blood biomarkers in patients with stenotic bicuspid aortic valve (BAV) and preserved ejection fraction (EF) by cardiovascular magnetic resonance (CMR). 43 stenotic BAV patients were prospectively selected for 3.0 T CMR. Patients were divided into LV remodeling group (LV mass/volume ≥ 1.15, n = 21) and non-remodeling group (LV mass/volume < 1.15, n = 22). Clinical characteristics, biochemical data including cardiac troponin T(cTNT), N-terminal pro-B type natriuretic peptide (NT-proBNP) and creatine kinase isoenzyme (CK-MB) were noted. Distensibility of middle ascending aorta (mid-AA) and proximal descending aorta, LV structural and functional parameters, global and regional myocardial strain were measured. Compared to non-remodeling group, LV remodeling group had significantly decreased LV global strain (radial: 26.04 ± 8.70% vs. 32.92 ± 7.81%, P = 0.009; circumferential: − 17.20 ± 3.38% vs. − 19.65 ± 2.34%, P = 0.008; longitudinal: − 9.13 ± 2.34% vs. − 11.63 ± 1.99%, P < 0.001) and decreased mid-AA distensibility (1.22 ± 0.24 10–3 mm/Hg vs 1.60 ± 0.41 10–3 mm/Hg, P = 0.001). In addition, mid-AA distensibility was independently associated with LV remodeling (β =  − 0.282, P = 0.003), and it was also significantly correlated with LV global strain (radial: r = 0.392, P = 0.009; circumferential: r =  − 0.348, P = 0.022; longitudinal: r =  − 0.333, P = 0.029), cTNT (r =  − 0.333, P = 0.029) and NT-proBNP (r =  − 0.440, P = 0.003). In this cohort with stenotic BAV and preserved EF, mid-AA distensibility is found significantly associated with LV remolding, which encouraging to better understand mechanism of ventricular vascular coupling.

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Funding

This work was supported by National Natural Science Foundation of China (Grant Numbers:81901818 and 82071991) and Shanghai Municipal Committee of Science and Technology, China (Grant Number:19ZR1451000).

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Authors and Affiliations

  1. Shanghai Institute of Medical Imaging, Shanghai, 200032, China

    Yijun Pan, Jiang Lin, Yongshi Wang, Pengju Xu, Mengsu Zeng & Yan Shan

  2. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China

    Yijun Pan, Jiang Lin, Pengju Xu, Mengsu Zeng & Yan Shan

  3. Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, 200032, China

    Yongshi Wang

  4. Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China

    Jun Li

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  1. Yijun Pan
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  2. Jiang Lin
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  4. Jun Li
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  5. Pengju Xu
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  7. Yan Shan
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Contributions

PY—data collection, analysis, manuscript draft; LJ—study design, manuscript review; WY, LJ—data collection, analysis; XP, ZM—manuscript review; SY—study design, data collection, manuscript review. All authors revised the paper and approved the final version.

Corresponding author

Correspondence to Yan Shan.

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All authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the local ethics committee of our institution (NO:B2020-232), and conformed to the ethical principles outlined in the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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Pan, Y., Lin, J., Wang, Y. et al. Association of aortic distensibility and left ventricular function in patients with stenotic bicuspid aortic valve and preserved ejection fraction: a CMR study. Int J Cardiovasc Imaging 38, 2025–2033 (2022). https://doi.org/10.1007/s10554-022-02581-4

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  • DOI: https://doi.org/10.1007/s10554-022-02581-4

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