Evaluation of bicuspid aortic valve-associated aortopathic changes using third-generation dual-source computed...

Area of Science:

• Cardiology
• Radiology
• Medical Imaging

Background:

• Bicuspid aortic valve (BAV) affects 0.5%-2% of the population, often leading to aortopathy and serious complications.
• Aortic size index (ASI), which normalizes aortic dimensions for body surface area (BSA), shows potential for improved risk stratification in BAV patients.

Purpose of the Study:

• To characterize aortopathy in Indian patients with BAV using third-generation dual-source CT.
• To establish a cohort-specific ASI threshold for identifying ascending aortic dilatation in this population.

Main Methods:

• A prospective study included 100 BAV patients (age > 18) undergoing CT aortography with a 192-slice dual-source CT scanner.
• Aortic dimensions were measured, and ASI was calculated (ascending aortic diameter/BSA).
• Statistical analyses included ROC curve analysis to determine the ASI threshold for aortic dilatation.

Main Results:

• 87% of BAV patients exhibited ascending aortic dilatation.
• An ASI cutoff of ≥ 23.8 mm/m² demonstrated 84% sensitivity and 90% specificity for predicting aortic dilatation > 40 mm.
• ASI strongly correlated with ascending aortic diameter (rho = 0.87, P < 0.001).

Conclusions:

• An ASI threshold of 23.8 mm/m² is associated with CT-defined ascending aortic dilatation in Indian BAV patients, serving as a potential cohort-specific risk stratification tool.
• This ASI threshold should be interpreted as a cohort-specific reference due to its mathematical derivation from aortic diameter.
• Third-generation dual-source CT provided larger aortic measurements than echocardiography, likely due to methodological differences.