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Altered aortic shape in bicuspid aortic valve relatives influences blood flow patterns
Susanne Schnell1, Danielle A Smith2, Alex J Barker3
1Department of Radiology, Northwestern University, 737 N. Michigan Avenue, Suite 1600, Chicago, IL 60611, USA susanne.schnell@northwestern.edu.
European Heart Journal. Cardiovascular Imaging
|July 28, 2016
Summary
Bicuspid aortic valve relatives show altered aortic shape and increased blood flow patterns, suggesting a heritable component of aortopathy independent of valve issues. This impacts aortic hemodynamics and shape.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Medical Imaging
Background:
- Bicuspid aortic valve (BAV) is linked to familial inheritance, aortopathy, and abnormal aortic hemodynamics.
- The independent inheritance of BAV-related aortopathy, separate from valve morphology, is not well understood.
Purpose of the Study:
- To investigate if aortic shape and blood flow alterations in BAV relatives with normal aortic valves suggest an inherited aortopathy.
- To assess the relationship between aortic shape and hemodynamic characteristics in individuals with a family history of BAV.
Main Methods:
- Utilized 4D flow MRI to assess thoracic aortic 3D blood flow in 24 BAV relatives (trileaflet valves) and 15 healthy controls.
- Analyzed aortic dimensions, shape (round, gothic, cubic), and blood flow characteristics (vortex/helix grading, peak velocities).
Main Results:
- BAV relatives exhibited a higher prevalence of gothic and cubic aortic shapes compared to controls (38% vs. 7%).
- Significantly increased ascending aorta (AAo) vortex flow was observed in BAV relatives (grading = 1.5 ± 1.0 vs. 0.6 ± 0.9, P = 0.015).
- Aortic shape influenced hemodynamics, with cubic and gothic shapes associated with increased vortex flow and altered peak velocities.
Conclusions:
- BAV relatives display altered aortic shape and elevated vortex flow, even without valvular disease or aortic dilation.
- Findings suggest a heritable component of BAV-related aortopathy affecting aortic morphology and blood flow dynamics, independent of valve structure.
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