Oscillatory shear stress is elevated in patients with bicuspid aortic valve and aortic regurgitation: a 4D flow cardiovascular magnetic resonance cross-sectional study.
Eur Heart J Cardiovasc Imaging
; 25(3): 404-412, 2024 Feb 22.
Article
em En
| MEDLINE
| ID: mdl-37878753
ABSTRACT
AIMS:
Patients with bicuspid aortic valve (BAV) and aortic regurgitation have higher rate of aortic complications compared with patients with BAV and stenosis, as well as BAV without valvular disease. Aortic regurgitation alters blood haemodynamics not only in systole but also during diastole. We therefore sought to investigate wall shear stress (WSS) during the whole cardiac cycle in BAV with aortic regurgitation. METHODS ANDRESULTS:
Fifty-seven subjects that underwent 4D flow cardiovascular magnetic resonance imaging were included 13 patients with BAVs without valve disease, 14 BAVs with aortic regurgitation, 15 BAVs with aortic stenosis, and 22 normal controls with tricuspid aortic valve. Peak and time averaged WSS in systole and diastole and the oscillatory shear index (OSI) in the ascending aorta were computed. Student's t-tests were used to compare values between the four groups where the data were normally distributed, and the non-parametric Wilcoxon rank sum tests were used otherwise. BAVs with regurgitation had similar peak and time averaged WSS compared with the patients with BAV without valve disease and with stenosis, and no regions of elevated WSS were found. BAV with aortic regurgitation had twice as high OSI as the other groups (P ≤ 0.001), and mainly in the outer mid-to-distal ascending aorta.CONCLUSION:
OSI uniquely characterizes altered WSS patterns in BAVs with aortic regurgitation, and thus could be a haemodynamic marker specific for this specific group that is at higher risk of aortic complications. Future longitudinal studies are needed to verify this hypothesis.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Insuficiência da Valva Aórtica
/
Doença da Válvula Aórtica Bicúspide
Limite:
Humans
Idioma:
En
Revista:
Eur Heart J Cardiovasc Imaging
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Suécia