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

Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain
Cardiology Department, Hospital Alvaro Cunqueiro, 36213 Vigo, Spain
Cardiology Department, Hospital Universitari Sant Joan de Reus, IISPV, Universitat Rovira i Virgili, 43204 Reus, Spain
Cardiology Department, University Hospital 12 de Octubre, 28041 Madrid, Spain
Cardiology Department, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84125 Salerno, Italy
Cardiology Department, Niguarda Ca’ Granda Hospital, 20162 Milan, Italy
Cardiology Department, Bassano del Grappa General Hospital, 36061 Bassano Del Grappa, Italy
Cardiology Department, Polyclinic Hospital of Bari, 70124 Bari, Italy
Instituto Cardiovascular San Isidro, Sanatorio Las Lomas, Buenos Aires 3031, Argentina
Cardiology Department, Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli, 80131 Napoli, Italy
Servei de Cardiologia, Hospital Josep Trueta, 17007 Girona, Spain
Heart Institute, Teknon Medical Center-Quirón Salud, 08022 Barcelona, Spain
Author to whom correspondence should be addressed.
Both first authors.
Academic Editor: Osama Soliman
J. Clin. Med. 2021, 10(22), 5264;
Received: 22 October 2021 / Revised: 5 November 2021 / Accepted: 9 November 2021 / Published: 12 November 2021
(This article belongs to the Special Issue State of the Art of Cardiac Multimodality Imaging)
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. View Full-Text
Keywords: bicuspid aortic valve; aneurysm; aortic stenosis; aortic regurgitation bicuspid aortic valve; aneurysm; aortic stenosis; aortic regurgitation
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MDPI and ACS Style

Lopez, A.; Dentamaro, I.; Galian, L.; Calvo, F.; Alegret, J.M.; Sanchez, V.; Citro, R.; Moreo, A.; Chirillo, F.; Colonna, P.; Carrero, M.C.; Bossone, E.; Moral, S.; Sao-Aviles, A.; Gutiérrez, L.; Teixido-Tura, G.; Rodríguez-Palomares, J.; Evangelista, A. Predictors of Ascending Aorta Enlargement and Valvular Dysfunction Progression in Patients with Bicuspid Aortic Valve. J. Clin. Med. 2021, 10, 5264.

AMA Style

Lopez A, Dentamaro I, Galian L, Calvo F, Alegret JM, Sanchez V, Citro R, Moreo A, Chirillo F, Colonna P, Carrero MC, Bossone E, Moral S, Sao-Aviles A, Gutiérrez L, Teixido-Tura G, Rodríguez-Palomares J, Evangelista A. Predictors of Ascending Aorta Enlargement and Valvular Dysfunction Progression in Patients with Bicuspid Aortic Valve. Journal of Clinical Medicine. 2021; 10(22):5264.

Chicago/Turabian Style

Lopez, Angela, Ilaria Dentamaro, Laura Galian, Francisco Calvo, Josep M. Alegret, Violeta Sanchez, Rodolfo Citro, Antonella Moreo, Fabio Chirillo, Paolo Colonna, María C. Carrero, Eduardo Bossone, Sergio Moral, Augusto Sao-Aviles, Laura Gutiérrez, Gisela Teixido-Tura, Jose Rodríguez-Palomares, and Arturo Evangelista. 2021. "Predictors of Ascending Aorta Enlargement and Valvular Dysfunction Progression in Patients with Bicuspid Aortic Valve" Journal of Clinical Medicine 10, no. 22: 5264.

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