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Prognostic role of aortic distensibility in patients with bicuspid aortic valve: a CMR study

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Abstract

To evaluate the prognostic value of aortic distensibility measured by cardiovascular magnetic resonance (CMR) as predictors of prophylactic aortic valve or aortic surgery in patients with bicuspid aortic valve (BAV). 110 patients with BAV were included. Distensibility of middle ascending aorta (AscAo) and proximal descending aorta (DescAo) at baseline was determined using CMR. The association between aortic distensibility and primary endpoint of aortic valve and/or aortic surgery was investigated with Cox proportional hazard regression analyses. The receiver operating characteristics curves (ROC) of the area under receiver-operator (AUC) and DeLong test were used to evaluate and compare the performance of different models. During a median follow-up of 66.5 months [IQR 13–75 months], 42 patients experienced surgical treatments. After adjusting for traditional risk factors, aortic distensibility (P = 0.003) and severe valve dysfunction (P < 0.001) were found significantly associated with aortic valve and/or aortic surgery. The model 2 (aortic distensibility and severe valve dysfunction) is slightly better in predicting primary endpoint than the model 1 (aortic diameter and severe valve dysfunction) (AUC: 0.893 vs. 0.842, P = 0.106). In BAV patients, aortic distensibility and severe valve dysfunction are valuable predictors for final aortic valve and/or aortic surgery.

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Funding

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

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Author notes

  1. Yan Shan and  Jiang Lin contributed equally to this work.

Authors and Affiliations

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

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

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

    Yongshi Wang

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

    Jun Li

Authors
  1. Yijun Pan
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  2. Yongshi Wang
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  3. Jun Li
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  4. Pengju Xu
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  5. Mengsu Zeng
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  6. Yan Shan
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  7. Jiang Lin
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Contributions

YP—data collection, analysis, manuscript draft; YW, JL—data collection, analysis; PX, MZ—manuscript review; YS, JL—study conception and design, manuscript review. All authors read and approved the final manuscript.

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Correspondence to Yan Shan.

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All authors declare that they have no conflict of interest.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the local ethics committee of our institution (No: B2020-232).

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

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Pan, Y., Wang, Y., Li, J. et al. Prognostic role of aortic distensibility in patients with bicuspid aortic valve: a CMR study. Int J Cardiovasc Imaging 39, 161–168 (2023). https://doi.org/10.1007/s10554-022-02710-z

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  • DOI: https://doi.org/10.1007/s10554-022-02710-z

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