Influence of cusp morphology and sex on quantitative valve composition in severe aortic stenosis.
Eur Heart J Cardiovasc Imaging
; 24(12): 1653-1660, 2023 11 23.
Article
em En
| MEDLINE
| ID: mdl-37339331
ABSTRACT
AIMS:
Aortic stenosis is characterized by fibrosis and calcification of the valve, with a higher proportion of fibrosis observed in women. Stenotic bicuspid aortic valves progress more rapidly than tricuspid valves, which may also influence the relative composition of the valve. We aimed to investigate the influence of cusp morphology on quantitative aortic valve composition quantified from contrast-enhanced computed tomography angiography in severe aortic stenosis. METHODS ANDRESULTS:
Patients undergoing transcatheter aortic valve implantation with bicuspid and tricuspid valves were propensity matched 11 by age, sex, and comorbidities. Computed tomography angiograms were analysed using semi-automated software to quantify the fibrotic and calcific scores (volume/valve annular area) and the fibro-calcific ratio (fibrotic score/calcific score). The study population (n = 140) was elderly (76 ± 10 years, 62% male) and had a peak aortic jet velocity of 4.1 ± 0.7 m/s. Compared with those with tricuspid valves (n = 70), patients with bicuspid valves (n = 70) had higher fibrotic scores [204 (interquartile range 118-267) vs. 144 (99-208) mm3/cm2, P = 0.006] with similar calcific scores (P = 0.614). Women had greater fibrotic scores than men in bicuspid [224 (181-307) vs. 169 (109-247) mm3/cm2, P = 0.042] but not tricuspid valves (P = 0.232). Men had greater calcific scores than women in both bicuspid [203 (124-355) vs. 130 (70-182) mm3/cm2, P = 0.008] and tricuspid [177 (136-249) vs. 100 (62-150) mm3/cm2, P = 0.004] valves. Among both valve types, women had a greater fibro-calcific ratio compared with men [tricuspid 1.86 (0.94-2.56) vs. 0.86 (0.54-1.24), P = 0.001 and bicuspid 1.78 (1.21-2.90) vs. 0.74 (0.44-1.53), P = 0.001].CONCLUSIONS:
In severe aortic stenosis, bicuspid valves have proportionately more fibrosis than tricuspid valves, especially in women.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Aórtica
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Substituição da Valva Aórtica Transcateter
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Doença da Válvula Aórtica Bicúspide
Limite:
Aged
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article