Effect of statins on aortic root growth rate in patients with bicuspid aortic valve anatomy

Bicuspid aortic valve (BAV) anatomy is associated with increased growth rate of the aortic root compared to tricuspid aortic valves. Statins decrease the growth rate of abdominal aneurysms; however their effect on the aortic root growth rate has not been elucidated. The present study evaluated the association between use of statins and aortic root growth in patients with BAV. A total of 199 patients (43 ± 15 years, 69% male) with BAV who underwent ≥ 2 echocardiographic measurements of the aortic root ≥ 1 year apart were included in this retrospective observational study. Median follow-up duration was 4.7 years (interquartile range 2.7-8.3 years). Growth rate (mm/year) of the aortic root was compared between statin users (n = 41) and non-users (n = 158). Statin users were significantly older and had more cardiovascular risk factors than their counterparts. Ascending aorta diameter was significantly smaller at baseline and at follow-up in statin users compared with non-users when adjusted for coronary artery disease, age and medication. The average annual growth rate was 0.08 mm/year (95% confidence interval 0.03-0.13) for the aortoventricular junction, 0.16 mm/year (0.11-0.21) for the sinus of Valsalva, 0.12 mm/year (0.07-0.17) for the sinotubular junction and 0.45 mm/year (0.37-0.53) for the ascending aorta. The dilation rate of the aortic segments was not different between statin users and non-users. In conclusion, in patients with BAV, although the use of statins was associated with smaller ascending aorta, the annual dilation rate of the aortic root was not influenced by the use of statins.