Abstract 14026: Inter-ethnic Differences in Bicuspid Aortic Valve Morphology, Valvular Dysfunction and Aortopathy : Result From a Large Multi-Center International Registry
Introduction: Bicuspid aortic valve (BAV) is the most common congenital valve defect. However, the inter-ethnic differences in morphology, valvular dysfunction and aortopathy data are lacking in the literature.
Hypothesis: To define the inter-ethnic differences in morphology, rate of significant aortic stenosis(AS)/regurgitation(AR) and diameters of various aortic segments (aortic annulus, sinus of Valsalva(SOV), sinotubular junction(STJ) and ascending aorta(AA)) between European and Asian patients with BAV.
Methods: In this multicenter retrospective study, we conducted comprehensive demographic and echocardiographic analyses of patients with BAV evaluated in an Europe center and 2 Singapore centers. BAV morphology was classified based on Sievers and Schmidtke’s classification and modified Fazel cluster classification was used to define patterns of aortic dilatation.
Results: In total 1,427 patients with BAV were included. Of those, 794 (55.6%) were Europeans and 633 (44.4%) were Asians. Asians had higher incidence of type 1 BAV with fusion of right and non-coronary cusps(L+R) than Europeans (19.7%vs. 13.6% ; P<0.001), whereas the Europeans had higher incidence of type 0 BAV than Asians (14.5% vs. 6.8% ; P<0.001). The incidence of significant AR was higher in Europeans than Asians (44.2% vs. 26.8% ; P<0.001) but incidence of significant AS was similar. Europeans had almost twice as much diffusely dilated aorta than Asians (14.4% vs. 8.7%, P=0.008). After the adjustment of demographics, comorbidities and valve function, aortic annulus was larger in Asians whereas Europeans had larger STJ (30.0±7.1 vs. 27.2±5.1mm, P=0.001) and AA (37.8±7.7 vs. 35.3±6.9mm, P=0.007).
Conclusions: This is the first multicenter registry to report BAV differences between 2 ethnicities. Type 1 BAV R+L was more frequent in Asians whereas diffuse dilatation of entire aorta was more frequent in Europeans. All these are suggestive of marked heterogeneity in the BAV population.
Author Disclosures: W.K. Kong: None. M. Vollema: None. M. Regeer: None. K. Poh: None. J. Yip: None. P. van Rosendael: None. T. Yeo: None. L. Ling: None. V. Kamperidis: None. M. Liang: None. E. Tay: None. E. van der Velde: None. B. Mertens: None. N.A. Marsan: None. V. Delgado: Research Grant; Modest; Abbot Vascular, Edward LifeScience. J.J. Bax: None.
- © 2016 by American Heart Association, Inc.