title: Ascending aorta dilatation in patients with bicuspid aortic valve stenosis: a prospective CMR study.
abstract: BACKGROUND
  The aim of this study was to evaluate the natural progression of aortic dilatation and its association with aortic valve stenosis (AoS) in patients with bicuspid aortic valve (BAV).
  
  
  METHODS
  Prospective study of aorta dilatation in patients with BAV and AoS using cardiac magnetic resonance (CMR). Aortic root, ascending aorta, aortic peak velocity, left ventricular systolic and diastolic function and mass were assessed at baseline and at 3-year follow-up.
  
  
  RESULTS
  Of the 33 enrolled patients, 5 needed surgery, while 28 patients (17 male; mean age: 31 ± 8 years) completed the study. Aortic diameters significantly increased at the aortic annulus, sinus of Valsalva and tubular ascending aorta levels (P < 0.050). The number of patients with dilated tubular ascending aortas increased from 32 % to 43 %. No significant increase in sino-tubular junction diameter was observed. Aortic peak velocity, ejection fraction and myocardial mass significantly increased while the early/late filling ratio significantly decreased at follow-up (P < 0.050). The progression rate of the ascending aorta diameter correlated weakly with the aortic peak velocity at baseline (R (2) = 0.16, P = 0.040).
  
  
  CONCLUSIONS
  BAV patients with AoS showed a progressive increase of aortic diameters with maximal expression at the level of the tubular ascending aorta. The progression of aortic dilatation correlated weakly with the severity of AoS.
authors.affiliation: Department of Cardiology, Erasmus University Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands. a.rossi@erasmusmc.nl
authors.forename: Alexia
authors.initials: A
authors.lastname: Rossi
authors.forename: Denise
authors.initials: D
authors.lastname: van der Linde
authors.forename: Sing Chien
authors.initials: SC
authors.lastname: Yap
authors.forename: Thomas
authors.initials: T
authors.lastname: Lapinskas
authors.forename: Sharon
authors.initials: S
authors.lastname: Kirschbaum
authors.forename: Tirza
authors.initials: T
authors.lastname: Springeling
authors.forename: Maarten
authors.initials: M
authors.lastname: Witsenburg
authors.forename: Judith
authors.initials: J
authors.lastname: Cuypers
authors.forename: Adriaan
authors.initials: A
authors.lastname: Moelker
authors.forename: Gabriel P
authors.initials: GP
authors.lastname: Krestin
authors.forename: Arie
authors.initials: A
authors.lastname: van Dijk
authors.forename: Mark
authors.initials: M
authors.lastname: Johnson
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.forename: Jolien W
authors.initials: JW
authors.lastname: Roos-Hesselink
mesh_terms: D000328:Adult; D001011:Aorta / Q000473:pathology*; D001021:Aortic Valve / Q000002:abnormalities / Q000473:pathology; D001024:Aortic Valve Stenosis / Q000473:pathology*; D000082882:Bicuspid Aortic Valve Disease; D004108:Dilatation, Pathologic / Q000150:complications / Q000473:pathology*; D006349:Heart Valve Diseases / Q000150:complications / Q000473:pathology*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity