Abstract 12308: Aortic Aneurysm Associated With Bicuspid Aortic Valve: Relation to Gender, Hemodynamics, and Valve Morphology: The NHLBI GenTAC Registry
Background: Aortic aneurysm phenotype in bicuspid aortic valve (BAV) may vary according to gender, hemodynamic alterations, and valve morphology (type of cusp fusion). To better understand these potential associations, BAV participants in the GenTAC Registry were analyzed.
Methods: 973 patients with BAV were enrolled (76.3% male; mean age 44.5 years). At time of enrollment, 549 (56.4%; 76.9% male) had undergone valvular and/or aortic surgery. Imaging data were available on 424 unoperated or pre-operative participants.
Results: Sinuses of Valsalva (SOV) diameter was larger in men than women (3.90 vs. 3.36 cm, p<0.0001); Z score: 2.2±2.3 vs. 1.4±1.9, p=0.002), whereas ascending aortic (AscAo) diameters were comparable (4.01 vs. 3.89, p=0.22; Z score: 3.2±2.0 vs. 3.5±2.2, p=0.124). BAV function was normal in 15.0%, predominantly regurgitant (AR) in 38.9%, predominantly stenotic (AS) in 21.6%, and mixed AS/AR in 16.0%. AR was more common in men (43.8 vs. 25.0%, p=0.003) whereas AS was more common in women (30.0 vs. 18.6%, p=0.033). Moderate-severe AR was associated with larger SOV diameters than mild AS (p=0.01) or moderate-severe AS (p=0.0006) or normal function (p<0.001). SOV diameters in mild AR were larger than those with normal function (p=0.012). Moderate-severe AS was associated with significantly larger AscAo diameter compared to normal function (p=0.002) but not compared to BAV with AR. AscAo diameters were larger in AR compared to normal function (both p<0.001).
Diameters of the SOV (3.70±0.67 vs. 3.36±0.56 cm, p=0.001) were larger in right-left fusion than in right-non fusion pattern whereas AscAo diameter was comparable.
Conclusions: In the GenTAC Registry, SOV diameters were larger in males, even after adjustment for body size. AR was associated with both SOV and AscAo enlargement whereas moderate-severe AS was only associated with AscAo enlargement. Aortic diameters were larger in those with right-left cusp fusion independent of valve function.
Author Disclosures: M.J. Roman: None. N.L. Pugh: None. J.E. Bavaria: None. R.B. Devereux: None. K.A. Eagle: Research Grant; Modest; Hewlett Foundation, Mardigian Foundation, Varbedian Fund, Bob & Ann Aikens Fund, WL GORE, Medtronic, Terumo. Consultant/Advisory Board; Modest; NIH NHLBI. K. Holmes: None. S.A. LeMaire: None. S.A. Morris: None. R. Pyeritz: None. W.J. Ravekes: None. F.M. Asch: None.
- © 2015 by American Heart Association, Inc.