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Eccentric Enlargement of the Aortic Sinuses in Pediatric and Adult Patients with Bicuspid Aortic Valves: A Cardiac MRI Study
Aortic root size and cusp fusion pattern have been related to disease outcomes in bicuspid aortic valve (BAV). This study seeks to characterize symmetry of the aortic sinuses in adult and pediatric BAV patients and its relationship to valvulopathy and root aortopathy. Aortic sinus-to-commissure (S-C...
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| Published in: | Pediatric cardiology 2020-02, Vol.41 (2), p.350-360 |
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| container_title | Pediatric cardiology |
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| creator | Stefek, Heather A. Lin, Kevin H. Rigsby, Cynthia K. Michelena, Hector I. Aouad, Pascale Barker, Alex J. Robinson, Joshua D. |
| description | Aortic root size and cusp fusion pattern have been related to disease outcomes in bicuspid aortic valve (BAV). This study seeks to characterize symmetry of the aortic sinuses in adult and pediatric BAV patients and its relationship to valvulopathy and root aortopathy. Aortic sinus-to-commissure (S-C) lengths were measured on cardiac MRI of adult and pediatric BAV patients with right-and-left coronary (RL) or right-and-non-coronary (RN) leaflet fusion and tricuspid aortic valve (TAV) controls. Coefficient of variance (CoV) of S-C lengths was calculated to quantify sinus asymmetry, or eccentricity. BAV cohort included 149 adults (48 ± 15 years) and 51 children (15 ± 5 years). TAV cohort included 40 adults (60 ± 13 years) and 20 children (15 ± 5 years). In adult and pediatric BAV patients, the non-fused aortic sinus was larger than either fused sinus. In RL fusion, the non-coronary S-C distance was larger than right or left S-C distances in adults (
n
= 121,
p
|
| doi_str_mv | 10.1007/s00246-019-02264-3 |
| format | article |
| fullrecord | <record><control><sourceid>gale_cross</sourceid><recordid>TN_cdi_gale_infotracmisc_A715517905</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A715517905</galeid><sourcerecordid>A715517905</sourcerecordid><originalsourceid>FETCH-LOGICAL-c381t-ef962c12af88f4338090ed803ad68dc5a83da02213d06f818de06f5e029978423</originalsourceid><addsrcrecordid>eNp9kV1rFTEQhoMo9lj9A15IwOttJ8l-ZL1bD0ctVCxWvQ0xmZym7GYPSbZS8Mcbu60giORiyMzzzMW8hLxkcMIAutMEwOu2AtZXwHlbV-IR2bBa8Ir1HXtMNsA6XkFbiyPyLKVrAJAgm6fkSDDZSA5sQ37ujMGQozd0F0Yd9ziVL50dzVdIhznmMrn0YUmYqA_0Aq3Xd7gOlg52GTO90NkXKdEfPl_Rt94s6eDtg_xNjzeY3tCBbnUssqEfP5_Ry7zY2-fkidNjwhf39Zh8fbf7sv1QnX96f7YdzisjJMsVur7lhnHtpHS1EBJ6QCtBaNtKaxothdXlAkxYaJ1k0mKpDQLv-07WXByT1-vevR5R-eDmHLWZfDJq6FjTsK6HplAn_6DKszh5Mwd0vvT_EvgqmDinFNGpQ_STjreKgfqdkFoTUiUhdZeQEkV6tUqH5fuE9o_yEEkBxAqkMgp7jOp6XmIo9_nf2l8jwJnm</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Eccentric Enlargement of the Aortic Sinuses in Pediatric and Adult Patients with Bicuspid Aortic Valves: A Cardiac MRI Study</title><source>Springer Nature</source><creator>Stefek, Heather A. ; Lin, Kevin H. ; Rigsby, Cynthia K. ; Michelena, Hector I. ; Aouad, Pascale ; Barker, Alex J. ; Robinson, Joshua D.</creator><creatorcontrib>Stefek, Heather A. ; Lin, Kevin H. ; Rigsby, Cynthia K. ; Michelena, Hector I. ; Aouad, Pascale ; Barker, Alex J. ; Robinson, Joshua D.</creatorcontrib><description>Aortic root size and cusp fusion pattern have been related to disease outcomes in bicuspid aortic valve (BAV). This study seeks to characterize symmetry of the aortic sinuses in adult and pediatric BAV patients and its relationship to valvulopathy and root aortopathy. Aortic sinus-to-commissure (S-C) lengths were measured on cardiac MRI of adult and pediatric BAV patients with right-and-left coronary (RL) or right-and-non-coronary (RN) leaflet fusion and tricuspid aortic valve (TAV) controls. Coefficient of variance (CoV) of S-C lengths was calculated to quantify sinus asymmetry, or eccentricity. BAV cohort included 149 adults (48 ± 15 years) and 51 children (15 ± 5 years). TAV cohort included 40 adults (60 ± 13 years) and 20 children (15 ± 5 years). In adult and pediatric BAV patients, the non-fused aortic sinus was larger than either fused sinus. In RL fusion, the non-coronary S-C distance was larger than right or left S-C distances in adults (
n
= 121,
p
< 0.001) and larger than the right S-C distance in children (
n
= 41,
p
= 0.013). Sinus eccentricity (CoV) in BAV patients was higher than in TAV patients (
p
< 0.001) and did not correlate with age (
p
= 0.12). CoV trended higher in RL adults with aortic regurgitation (AR) compared to those without AR (
p
= 0.081), but was lower in RN adults with AR than without AR (
p
= 0.006). CoV did not correlate to root
Z
scores (
p
= 0.06–0.55) or ascending aortic (AAo)
Z
scores in adults (
p
= 0.45–0.55) but correlated negatively to AAo
Z
score in children (
p
= 0.005–0.03). Most adult and pediatric BAV patients with RL and RN leaflet fusion demonstrate eccentric dominance of the non-fused aortic sinus irrespective of age. The degree of eccentricity varies with valve dysfunction and BAV phenotype but does not relate to the degree of aortic root dilatation, nor does eccentricity correlate with ascending aorta dilatation in adults.</description><identifier>ISSN: 0172-0643</identifier><identifier>EISSN: 1432-1971</identifier><identifier>DOI: 10.1007/s00246-019-02264-3</identifier><identifier>PMID: 31858201</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adolescent ; Adult ; Adults ; Aorta - diagnostic imaging ; Aorta - pathology ; Aortic Valve - abnormalities ; Aortic Valve - diagnostic imaging ; Aortic Valve - pathology ; Bicuspid Aortic Valve Disease ; Cardiac Surgery ; Cardiology ; Child ; Epidemiology ; Female ; Gadobutrol ; Gadofosveset ; Heart valve diseases ; Heart Valve Diseases - etiology ; Heart Valve Diseases - pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Medical imaging equipment ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Pediatrics ; Retrospective Studies ; Sinus of Valsalva - diagnostic imaging ; Sinus of Valsalva - pathology ; Vascular Surgery ; Young Adult</subject><ispartof>Pediatric cardiology, 2020-02, Vol.41 (2), p.350-360</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>COPYRIGHT 2020 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c381t-ef962c12af88f4338090ed803ad68dc5a83da02213d06f818de06f5e029978423</citedby><cites>FETCH-LOGICAL-c381t-ef962c12af88f4338090ed803ad68dc5a83da02213d06f818de06f5e029978423</cites><orcidid>0000-0002-0991-9836</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31858201$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stefek, Heather A.</creatorcontrib><creatorcontrib>Lin, Kevin H.</creatorcontrib><creatorcontrib>Rigsby, Cynthia K.</creatorcontrib><creatorcontrib>Michelena, Hector I.</creatorcontrib><creatorcontrib>Aouad, Pascale</creatorcontrib><creatorcontrib>Barker, Alex J.</creatorcontrib><creatorcontrib>Robinson, Joshua D.</creatorcontrib><title>Eccentric Enlargement of the Aortic Sinuses in Pediatric and Adult Patients with Bicuspid Aortic Valves: A Cardiac MRI Study</title><title>Pediatric cardiology</title><addtitle>Pediatr Cardiol</addtitle><addtitle>Pediatr Cardiol</addtitle><description>Aortic root size and cusp fusion pattern have been related to disease outcomes in bicuspid aortic valve (BAV). This study seeks to characterize symmetry of the aortic sinuses in adult and pediatric BAV patients and its relationship to valvulopathy and root aortopathy. Aortic sinus-to-commissure (S-C) lengths were measured on cardiac MRI of adult and pediatric BAV patients with right-and-left coronary (RL) or right-and-non-coronary (RN) leaflet fusion and tricuspid aortic valve (TAV) controls. Coefficient of variance (CoV) of S-C lengths was calculated to quantify sinus asymmetry, or eccentricity. BAV cohort included 149 adults (48 ± 15 years) and 51 children (15 ± 5 years). TAV cohort included 40 adults (60 ± 13 years) and 20 children (15 ± 5 years). In adult and pediatric BAV patients, the non-fused aortic sinus was larger than either fused sinus. In RL fusion, the non-coronary S-C distance was larger than right or left S-C distances in adults (
n
= 121,
p
< 0.001) and larger than the right S-C distance in children (
n
= 41,
p
= 0.013). Sinus eccentricity (CoV) in BAV patients was higher than in TAV patients (
p
< 0.001) and did not correlate with age (
p
= 0.12). CoV trended higher in RL adults with aortic regurgitation (AR) compared to those without AR (
p
= 0.081), but was lower in RN adults with AR than without AR (
p
= 0.006). CoV did not correlate to root
Z
scores (
p
= 0.06–0.55) or ascending aortic (AAo)
Z
scores in adults (
p
= 0.45–0.55) but correlated negatively to AAo
Z
score in children (
p
= 0.005–0.03). Most adult and pediatric BAV patients with RL and RN leaflet fusion demonstrate eccentric dominance of the non-fused aortic sinus irrespective of age. The degree of eccentricity varies with valve dysfunction and BAV phenotype but does not relate to the degree of aortic root dilatation, nor does eccentricity correlate with ascending aorta dilatation in adults.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adults</subject><subject>Aorta - diagnostic imaging</subject><subject>Aorta - pathology</subject><subject>Aortic Valve - abnormalities</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - pathology</subject><subject>Bicuspid Aortic Valve Disease</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Child</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Gadobutrol</subject><subject>Gadofosveset</subject><subject>Heart valve diseases</subject><subject>Heart Valve Diseases - etiology</subject><subject>Heart Valve Diseases - pathology</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical imaging equipment</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Pediatrics</subject><subject>Retrospective Studies</subject><subject>Sinus of Valsalva - diagnostic imaging</subject><subject>Sinus of Valsalva - pathology</subject><subject>Vascular Surgery</subject><subject>Young Adult</subject><issn>0172-0643</issn><issn>1432-1971</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kV1rFTEQhoMo9lj9A15IwOttJ8l-ZL1bD0ctVCxWvQ0xmZym7GYPSbZS8Mcbu60giORiyMzzzMW8hLxkcMIAutMEwOu2AtZXwHlbV-IR2bBa8Ir1HXtMNsA6XkFbiyPyLKVrAJAgm6fkSDDZSA5sQ37ujMGQozd0F0Yd9ziVL50dzVdIhznmMrn0YUmYqA_0Aq3Xd7gOlg52GTO90NkXKdEfPl_Rt94s6eDtg_xNjzeY3tCBbnUssqEfP5_Ry7zY2-fkidNjwhf39Zh8fbf7sv1QnX96f7YdzisjJMsVur7lhnHtpHS1EBJ6QCtBaNtKaxothdXlAkxYaJ1k0mKpDQLv-07WXByT1-vevR5R-eDmHLWZfDJq6FjTsK6HplAn_6DKszh5Mwd0vvT_EvgqmDinFNGpQ_STjreKgfqdkFoTUiUhdZeQEkV6tUqH5fuE9o_yEEkBxAqkMgp7jOp6XmIo9_nf2l8jwJnm</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Stefek, Heather A.</creator><creator>Lin, Kevin H.</creator><creator>Rigsby, Cynthia K.</creator><creator>Michelena, Hector I.</creator><creator>Aouad, Pascale</creator><creator>Barker, Alex J.</creator><creator>Robinson, Joshua D.</creator><general>Springer US</general><general>Springer</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><orcidid>https://orcid.org/0000-0002-0991-9836</orcidid></search><sort><creationdate>20200201</creationdate><title>Eccentric Enlargement of the Aortic Sinuses in Pediatric and Adult Patients with Bicuspid Aortic Valves: A Cardiac MRI Study</title><author>Stefek, Heather A. ; Lin, Kevin H. ; Rigsby, Cynthia K. ; Michelena, Hector I. ; Aouad, Pascale ; Barker, Alex J. ; Robinson, Joshua D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c381t-ef962c12af88f4338090ed803ad68dc5a83da02213d06f818de06f5e029978423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adults</topic><topic>Aorta - diagnostic imaging</topic><topic>Aorta - pathology</topic><topic>Aortic Valve - abnormalities</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - pathology</topic><topic>Bicuspid Aortic Valve Disease</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Child</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Gadobutrol</topic><topic>Gadofosveset</topic><topic>Heart valve diseases</topic><topic>Heart Valve Diseases - etiology</topic><topic>Heart Valve Diseases - pathology</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical imaging equipment</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Pediatrics</topic><topic>Retrospective Studies</topic><topic>Sinus of Valsalva - diagnostic imaging</topic><topic>Sinus of Valsalva - pathology</topic><topic>Vascular Surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stefek, Heather A.</creatorcontrib><creatorcontrib>Lin, Kevin H.</creatorcontrib><creatorcontrib>Rigsby, Cynthia K.</creatorcontrib><creatorcontrib>Michelena, Hector I.</creatorcontrib><creatorcontrib>Aouad, Pascale</creatorcontrib><creatorcontrib>Barker, Alex J.</creatorcontrib><creatorcontrib>Robinson, Joshua D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Pediatric cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stefek, Heather A.</au><au>Lin, Kevin H.</au><au>Rigsby, Cynthia K.</au><au>Michelena, Hector I.</au><au>Aouad, Pascale</au><au>Barker, Alex J.</au><au>Robinson, Joshua D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Eccentric Enlargement of the Aortic Sinuses in Pediatric and Adult Patients with Bicuspid Aortic Valves: A Cardiac MRI Study</atitle><jtitle>Pediatric cardiology</jtitle><stitle>Pediatr Cardiol</stitle><addtitle>Pediatr Cardiol</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>41</volume><issue>2</issue><spage>350</spage><epage>360</epage><pages>350-360</pages><issn>0172-0643</issn><eissn>1432-1971</eissn><abstract>Aortic root size and cusp fusion pattern have been related to disease outcomes in bicuspid aortic valve (BAV). This study seeks to characterize symmetry of the aortic sinuses in adult and pediatric BAV patients and its relationship to valvulopathy and root aortopathy. Aortic sinus-to-commissure (S-C) lengths were measured on cardiac MRI of adult and pediatric BAV patients with right-and-left coronary (RL) or right-and-non-coronary (RN) leaflet fusion and tricuspid aortic valve (TAV) controls. Coefficient of variance (CoV) of S-C lengths was calculated to quantify sinus asymmetry, or eccentricity. BAV cohort included 149 adults (48 ± 15 years) and 51 children (15 ± 5 years). TAV cohort included 40 adults (60 ± 13 years) and 20 children (15 ± 5 years). In adult and pediatric BAV patients, the non-fused aortic sinus was larger than either fused sinus. In RL fusion, the non-coronary S-C distance was larger than right or left S-C distances in adults (
n
= 121,
p
< 0.001) and larger than the right S-C distance in children (
n
= 41,
p
= 0.013). Sinus eccentricity (CoV) in BAV patients was higher than in TAV patients (
p
< 0.001) and did not correlate with age (
p
= 0.12). CoV trended higher in RL adults with aortic regurgitation (AR) compared to those without AR (
p
= 0.081), but was lower in RN adults with AR than without AR (
p
= 0.006). CoV did not correlate to root
Z
scores (
p
= 0.06–0.55) or ascending aortic (AAo)
Z
scores in adults (
p
= 0.45–0.55) but correlated negatively to AAo
Z
score in children (
p
= 0.005–0.03). Most adult and pediatric BAV patients with RL and RN leaflet fusion demonstrate eccentric dominance of the non-fused aortic sinus irrespective of age. The degree of eccentricity varies with valve dysfunction and BAV phenotype but does not relate to the degree of aortic root dilatation, nor does eccentricity correlate with ascending aorta dilatation in adults.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31858201</pmid><doi>10.1007/s00246-019-02264-3</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-0991-9836</orcidid></addata></record> |
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| ispartof | Pediatric cardiology, 2020-02, Vol.41 (2), p.350-360 |
| issn | 0172-0643 1432-1971 |
| language | eng |
| recordid | cdi_gale_infotracmisc_A715517905 |
| source | Springer Nature |
| subjects | Adolescent Adult Adults Aorta - diagnostic imaging Aorta - pathology Aortic Valve - abnormalities Aortic Valve - diagnostic imaging Aortic Valve - pathology Bicuspid Aortic Valve Disease Cardiac Surgery Cardiology Child Epidemiology Female Gadobutrol Gadofosveset Heart valve diseases Heart Valve Diseases - etiology Heart Valve Diseases - pathology Humans Magnetic Resonance Imaging Male Medical imaging equipment Medicine Medicine & Public Health Middle Aged Original Article Pediatrics Retrospective Studies Sinus of Valsalva - diagnostic imaging Sinus of Valsalva - pathology Vascular Surgery Young Adult |
| title | Eccentric Enlargement of the Aortic Sinuses in Pediatric and Adult Patients with Bicuspid Aortic Valves: A Cardiac MRI Study |
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