Korean Journal of Radiology

  • 제22권6호
  • /
  • Pages.890-900
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  • 2021
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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The Association between Morphological and Functional Characteristics of the Bicuspid Aortic Valve and Bicuspid Aortopathy

  • Bo Hwa Choi (Department of Radiology, National Cancer Center) ;
  • Sung Min Ko (Department of Radiology, Wonju Severance Christian Hospital, Yonsei Wonju College of Medicine) ;
  • Je Kyoun Shin (Department of Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Hyun Keun Chee (Department of Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Jun Seok Kim (Department of Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine)
  • 투고 : 2020.05.03
  • 심사 : 2020.11.03
  • 발행 : 2021.06.01
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초록

Objective: To identify the association between morphological and functional characteristics of the bicuspid aortic valve (BAV) and bicuspid aortopathy and to identify the determinants of aortic dilatation using transthoracic echocardiography (TTE) and cardiac computed tomography (CCT). Materials and Methods: This study included 312 subjects (mean [SD] age, 52.7 [14.3] years; 227 males [72.8%]) who underwent TTE and CCT. The BAVs were classified by anterior-posterior (BAV-AP) or right-left (BAV-RL) orientation of the cusps and divided according to the presence (raphe+) or absence of a raphe (raphe-) based on the CCT and intraoperative findings. The dimensions of the sinus of Valsalva and the proximal ascending aorta were measured by CCT. We assessed the determinants of aortic root and proximal ascending aortic dilatation (size index > 2.1 cm/m2) by Univariable and multivariable logistic regression analyses. Results: Of the 312 patients, BAV-AP was present in 188 patients (60.3%), and 185 patients (59.3%) were raphe+. Moderate-to-severe aortic stenosis (AS) was the most common hemodynamic abnormality (54.8%). The most common type of aortopathy was the combined dilated root and mid-ascending aortic phenotype (62.5%). On multivariable analysis, age and AS severity were significantly associated with aortic root dilatation (p < 0.05), and age, sex, and AS severity were significantly associated with ascending aortic dilatation (p < 0.05). However, the orientation of the cusps, presence of a raphe, and severity of aortic regurgitation were not associated with aortic root and ascending aortic dilatation. Conclusion: BAV morphological characteristics were not determinants of aortic dilatation. Age, sex, and AS severity were predictors of bicuspid aortopathy. Therefore, age, sex, and AS severity, rather than valve morphology, need to be considered when planning treatment for BAV patients.

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참고문헌

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