title: Ascending Aortic Stiffness with Bicuspid Aortic Valve is Variable and Not Predicted by Conventional Parameters in Young Patients.
abstract: Bicuspid aortic valve (BAV)-related aortopathy is characterized by histological abnormalities that result in aortic wall stiffening and aortic dilation. The study aim was to determine the range of ascending aortic stiffness seen in a clinical cohort of patients with BAV, and to identify the association of aortic stiffness with standard clinical and imaging parameters.
  
  
  
  Patients with BAV (n = 65) and normal subjects (n = 10) were studied using conventional phase-contrast magnetic resonance imaging through the ascending aorta. Local aortic stiffness was estimated by measuring pulse wave velocity (PWV) using the flow-area (QA) method. Correlations between PWV and other imaging and clinical variables were assessed, and multiple linear regression models were used to examine independent predictors of PWV.
  
  
  
  BAV patients demonstrated a significantly higher mean PWV compared to normal subjects (6.53 ± 5.88 versus 3.51 ± 0.92 m/s; p <0.01) with a considerably wider range of values noted in the BAV group. Significant associations were found between PWV and age (r = 0.4, p <0.001) and history of hypertension (r = 0.36, p = 0.005) in the overall BAV cohort. The correlation between age and PWV was significantly strengthened above 40 years of age. In a subgroup of BAV patients aged <40 years (n = 37) there were no significant predictors of PWV identified by multiple linear regression models.
  
  
  
  BAV patients demonstrated an increased average ascending aortic stiffness and a dramatically higher range of stiffness values compared to normal subjects. Increased stiffness is not predicted by standard clinical or imaging parameters in patients aged <40 years. Ascending aortic stiffness may be a unique marker of early aortic dysfunction in young BAV patients.
authors.affiliation: Department of Radiology, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Burris
authors.affiliation: Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
authors.forename: Petter
authors.initials: P
authors.lastname: Dyverfeldt
authors.affiliation: Department of Radiology, University of California San Francisco, San Francisco, CA, USA. Electronic correspondence: Michael.Hope@ucsf.edu.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hope
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D001021:Aortic Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology; D000082882:Bicuspid Aortic Valve Disease; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D016014:Linear Models; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D063177:Pulse Wave Analysis; D015203:Reproducibility of Results; D012307:Risk Factors; D059289:Vascular Stiffness; D055815:Young Adult