title: Functional Aortic Root Parameters and Expression of Aortopathy in Bicuspid Versus Tricuspid Aortic Valve Stenosis.
abstract: BACKGROUND
  The correlation between bicuspid aortic valve (BAV) disease and aortopathy is not fully defined.
  
  
  OBJECTIVE
  This study aimed to prospectively analyze the correlation between functional parameters of the aortic root and expression of aortopathy in patients undergoing surgery for BAV versus tricuspid aortic valve (TAV) stenosis.
  
  
  METHODS
  From January 1, 2012 through December 31, 2014, 190 consecutive patients (63 ± 8 years, 67% male) underwent aortic valve replacement ± proximal aortic surgery for BAV stenosis (n = 137, BAV group) and TAV stenosis (n = 53, TAV group). All patients underwent pre-operative cardiac magnetic resonance imaging to evaluate morphological/functional parameters of the aortic root. Aortic tissue was sampled during surgery on the basis of the location of eccentric blood flow contact with the aortic wall, as determined by cardiac magnetic resonance (i.e., jet sample and control sample). Aortic wall lesions were graded using a histological sum score (0 to 21).
  
  
  RESULTS
  The largest cross-sectional aortic diameters were at the mid-ascending level in both groups and were larger in BAV patients (40.2 ± 7.2 mm vs. 36.6 ± 3.3 mm, respectively, p < 0.001). The histological sum score was 2.9 ± 1.4 in the BAV group versus 3.4 ± 2.6 in the TAV group (p = 0.4). The correlation was linear and comparable between the maximum indexed aortic diameter and the angle between the left ventricular outflow axis and aortic root (left ventricle/aorta angle) in both groups (BAV group: r = 0.6, p < 0.001 vs. TAV group r = 0.45, p = 0.03, z = 1.26, p = 0.2). Logistic regression identified the left ventricle/aorta angle as an indicator of indexed aortic diameter >22 mm/m(2) (odds ratio: 1.2; p < 0.001).
  
  
  CONCLUSIONS
  Comparable correlation patterns between functional aortic root parameters and expression of aortopathy are found in patients with BAV versus TAV stenosis.
authors.affiliation: Department of Cardiovascular Surgery, University Heart Center, Hamburg, Germany. Electronic address: e.girdauskas@uke.de.
authors.forename: Evaldas
authors.initials: E
authors.lastname: Girdauskas
authors.affiliation: Department of Cardiac Surgery, Central Hospital, Bad Berka, Germany.
authors.forename: Mina
authors.initials: M
authors.lastname: Rouman
authors.affiliation: Department of Cardiac Surgery, Central Hospital, Bad Berka, Germany.
authors.forename: Kushtrim
authors.initials: K
authors.lastname: Disha
authors.affiliation: Department of Radiology, Central Hospital, Bad Berka, Germany.
authors.forename: Beatrix
authors.initials: B
authors.lastname: Fey
authors.affiliation: Department of Radiology, Central Hospital, Bad Berka, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Dubslaff
authors.affiliation: Institute of Pathology, Friedrich-Schiller University, Jena, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Theis
authors.affiliation: Institute of Pathology, Friedrich-Schiller University, Jena, Germany.
authors.forename: Iver
authors.initials: I
authors.lastname: Petersen
authors.affiliation: Department of Radiology, Heart Center, Leipzig, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Gutberlet
authors.affiliation: Columbia University Medical Center, New York, New York.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Borger
authors.affiliation: Department of Cardiac Surgery, Central Hospital, Bad Berka, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kuntze
mesh_terms: D000368:Aged; D001011:Aorta / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D001021:Aortic Valve / Q000002:abnormalities* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology; D000082882:Bicuspid Aortic Valve Disease; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic
keywords: aorta; bicuspid aortic valve; hemodynamics; valves