Low and Oscillatory Wall Shear Stress Is Not Related to Aortic Dilation in Patients With Bicuspid Aortic Valve

Supplemental Digital Content is available in the text. To assess the relationship between regional wall shear stress (WSS) and oscillatory shear index (OSI) and aortic dilation in patients with bicuspid aortic valve (BAV). Forty-six consecutive patients with BAV (63% with right-left-coronary-cusp fu...

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Detalles Bibliográficos
Autores: Dux-Santoy, Lydia|||0000-0001-8736-2095, Guala, Andrea|||0000-0002-5006-8164, Sotelo, Julio, Uribe, Sergio, Teixido-Tura, Gisela|||0000-0003-4714-2420, Ruiz Muñoz, Aroa|||0000-0002-1138-8528, Hurtado, Daniel E., Valente, Filipa|||0000-0002-5569-3292, Galian-Gay, Laura|||0000-0001-6828-5928, Gutiérrez García-Moreno, Laura, González-Alujas, Teresa, Johnson, Kevin M., Wieben, Oliver, Ferreira-Gonzalez, Ignacio|||0000-0002-1208-5561, Evangelista Masip, Arturo|||0000-0001-8182-1174, Rodríguez Palomares, José F.|||0000-0002-7229-9780
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:235412
Acceso en línea:https://ddd.uab.cat/record/235412
https://dx.doi.org/urn:doi:10.1161/ATVBAHA.119.313636
Access Level:acceso abierto
Palabra clave:Aorta
Bicuspid aortic valve
Magnetic resonance imaging
Mechanical stress
Regional blood flow
Thoracic aortic aneurysm
Vascular remodeling
Descripción
Sumario:Supplemental Digital Content is available in the text. To assess the relationship between regional wall shear stress (WSS) and oscillatory shear index (OSI) and aortic dilation in patients with bicuspid aortic valve (BAV). Forty-six consecutive patients with BAV (63% with right-left-coronary-cusp fusion, aortic diameter ≤ 45 mm and no severe valvular disease) and 44 healthy volunteers were studied by time-resolved 3-dimensional phase-contrast magnetic resonance imaging. WSS and OSI were quantified at different levels of the ascending aorta and the aortic arch, and regional WSS and OSI maps were obtained. Seventy percent of BAV had ascending aorta dilation. Compared with healthy volunteers, patients with BAV had increased WSS and decreased OSI in most of the ascending aorta and the aortic arch. In both BAV and healthy volunteers, regions of high WSS matched regions of low OSI and vice versa. No regions of both low WSS and high OSI were identified in BAV compared with healthy volunteers. Patients with BAV with dilated compared with nondilated aorta presented low and oscillatory WSS in the aortic arch, but not in the ascending aorta where dilation is more prevalent. Furthermore, no regions of concomitant low WSS and high OSI were identified when BAV were compared according to leaflet fusion pattern, despite the well-known differences in regional dilation prevalence. Regions with low WSS and high OSI do not match those with the highest prevalence of dilation in patients with BAV, thus providing no evidence to support the low and oscillatory shear stress theory in the pathogenesis of proximal aorta dilation in the presence of BAV.

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