Implications of Asymmetry and Valvular Morphotype on Echocardiographic Measurements of the Aortic Root in Bicuspid Aortic Valve - 03/01/19
Abstract |
Background |
Transthoracic echocardiography (TTE) and magnetic resonance imaging (MRI) have yielded excellent results in aortic root diameter measurement in patients with tricuspid aortic valve. However, accuracy in bicuspid aortic valve (BAV), often associated with aortic root asymmetry, is not fully defined. The aim of this study was to determine the agreement between TTE and MRI in proximal ascending aortic diameters in patients with BAVs.
Methods |
Seventy-six consecutive patients with BAVs (mean age, 53 ± 15 years; 65% men) who underwent both TTE and MRI for ascending aortic assessment in a follow-up protocol were included in the study. Maximum aortic root and ascending aortic diameters were compared.
Results |
For the whole population, TTE slightly underestimated aortic root diameter (difference, −0.8 ± 2.9 mm; P = .02). However, agreement was significantly better in BAV with fusion of the left and right coronary cusps than with fusion of the right coronary and noncoronary cusps, both with (type 1) and without (type 0) raphe (mean difference, 0.1 ± 2.5 vs −2.8 ± 2.8 mm, P < .001, respectively). In raphe BAV, mean absolute differences of maximum diameters between both techniques were significantly greater in asymmetric versus symmetric aortic roots (3.3 ± 2.2 vs 1.6 ± 1.9 mm, P = .002). BAV type and root asymmetry were independent related to measurement disagreement between both modalities.
Conclusions |
Although TTE is the technique of choice in the follow-up of patients with BAVs, aortic root diameter measurements may be inaccurate in the presence of root asymmetry and in BAV with fusion of the right coronary and noncoronary cusps. In these cases, cross-sectional imaging, with MRI or computed tomography, to confirm aortic diameters may be advisable.
Le texte complet de cet article est disponible en PDF.Highlights |
• | In patients with BAVs, TTE slightly underestimated aortic root diameter. |
• | In BAV, aortic diameter differences by TTE and MRI are ≥3 mm in 39% of cases. |
• | Root asymmetry increases aortic root diameter differences between TTE and MRI in BAV. |
• | In BAV-RN, underestimation of aortic root diameter may be significant. |
• | TTE-PSAX helps in root asymmetry diagnosis but has low diameter reproducibility. |
Keywords : Bicuspid aortic valve, Asymmetric aortic root, Multimodality assessment
Abbreviations : 2D, 3D, BAV, BAV-LR, BAV-RN, I-I, L-L, MRI, NCC, RCC, TTE, TTE-PLAX, TTE-PSAX
Plan
| This work was supported by grants from Fondo de Investigación Sanitaria, Red de Investigación Cooperativa de las Enfermedades Cardiovasculares, CIBER-CV, Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, and cofunded by the European Union (ERDF/ESF; FIS-PI11/01081) and by La Marató (170/C/2015). Dr. Vis received an individual unrestricted research grant from the European Society of Cardiology. |
Vol 32 - N° 1
P. 105-112 - janvier 2019 Retour au numéro
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