title: Ascending aortic dilatation is rarely associated with coronary artery disease regardless of aortic valve morphology.
abstract: OBJECTIVE
  Differences in clinical presentation between patients with tricuspid aortic valves (TAVs) or bicuspid aortic valves (BAVs) and aortic valve disease are evident. Whether these differences can be attributed to differences in cardiovascular risks remains uncertain.
  
  
  METHODS
  Patient characteristics, echocardiographic findings, medical history, medication, and laboratory findings were evaluated in 702 patients with aortic valve and/or ascending aortic pathology; 202 also had concomitant coronary artery disease.
  
  
  RESULTS
  A BAV was commonly found in patients with isolated valve disease (BAV 47%, TAV 53%) and frequently associated with ascending aortic dilatation (BAV 80%, TAV 20%). In patients with coronary artery disease, a TAV was commonly found (TAV 84%, BAV 16%). The combination of ascending aortic dilatation and coronary artery disease was markedly rare regardless of valve morphology (TAV, 7 out of 38; BAV, 6 out of 127). The distribution of valve pathology and clinical parameters was similar in patients with TAV and BAV with coronary artery disease (P ≥ .12). Without coronary artery disease, parameters associated with cardiovascular risks were more often seen in patients with TAV than in patients with BAV (P ≤ .0001).
  
  
  CONCLUSIONS
  Coronary artery disease is uncommon in surgical patients with BAV, but it is associated with TAV, advanced age, and male gender. Coronary artery disease and ascending aortic dilatation rarely coexist, regardless of valve phenotype. Differences in the prevalence of coronary artery disease or ascending aortic dilatation between patients with TAV and BAV are not explained by differences in cardiovascular risks or the distribution of valve pathology.
authors.affiliation: Cardiothoracic Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. Electronic address: Veronica.Jackson@karolinska.se.
authors.forename: Veronica
authors.initials: V
authors.lastname: Jackson
authors.affiliation: Clinical Physiology Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Eriksson
authors.affiliation: Clinical Physiology Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Caidahl
authors.affiliation: Atherosclerosis Research Unit at the Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Eriksson
authors.affiliation: Cardiothoracic Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Franco-Cereceda
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D019917:Blood Vessel Prosthesis Implantation; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D004108:Dilatation, Pathologic; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology