TY - JOUR
T1 - Regional Aortic Wall Shear Stress Increases over Time in Patients with a Bicuspid Aortic Valve
AU - Minderhoud, Savine
AU - Arrouby, Aïmane
AU - van den Hoven, Allard
AU - Bons, Lidia
AU - Chelu, Raluca
AU - Kardys, Isabella
AU - Rizopoulos, Dimitris
AU - Korteland, SA (Suze-Anne)
AU - van den Bosch, Annemien
AU - Budde, Ricardo
AU - Hesselink, Jolien
AU - Wentzel, Jolanda
AU - Hirsch, Alexander
N1 - Publisher Copyright:
© 2024 The Author(s)
PY - 2024/12/1
Y1 - 2024/12/1
N2 - Background: Aortic wall shear stress (WSS) is a known predictor of ascending aortic growth in patients with a bicuspid aortic valve (BAV). The aim of this study was to study regional WSS and changes over time in BAV patients. Methods: BAV patients and age-matched healthy controls underwent four-dimensional (4D) flow cardiovascular magnetic resonance (CMR). Regional, peak systolic ascending aortic WSS, aortic valve function, aortic stiffness measures, and aortic dimensions were assessed. In BAV patients, 4D flow CMR was repeated after 3 years of follow-up and both at baseline and follow-up computed tomography angiography (CTA) were acquired. Aortic growth (volume increase of ≥5%) was measured on CTA. Regional WSS differences within patients’ aorta and WSS changes over time were analyzed using linear mixed-effect models and were associated with clinical parameters. Results: Thirty BAV patients (aged 34 years [interquartile range (IQR) 25–41]) were included in the follow-up analysis. Additionally, another 16 BAV patients and 32 healthy controls (aged 33 years [IQR 28–48]) were included for other regional analyses. Magnitude, axial, and circumferential WSS increased over time (all p < 0.001) irrespective of aortic growth. The percentage of regions exposed to a magnitude WSS >95th percentile of healthy controls increased from 21% (baseline 506/2400 regions) to 31% (follow-up 734/2400 regions) (p < 0.001). WSS angle, a measure of helicity near the aortic wall, decreased during follow-up. Magnitude WSS changes over time were associated with systolic blood pressure, peak aortic valve velocity, aortic valve regurgitation fraction, aortic stiffness indexes, and normalized flow displacement (all p < 0.05). Conclusion: An increase in regional WSS over time was observed in BAV patients, irrespective of aortic growth. The increasing WSSs, comprising a larger area of the aorta, warrant further research to investigate the possible predictive value for aortic dissection.
AB - Background: Aortic wall shear stress (WSS) is a known predictor of ascending aortic growth in patients with a bicuspid aortic valve (BAV). The aim of this study was to study regional WSS and changes over time in BAV patients. Methods: BAV patients and age-matched healthy controls underwent four-dimensional (4D) flow cardiovascular magnetic resonance (CMR). Regional, peak systolic ascending aortic WSS, aortic valve function, aortic stiffness measures, and aortic dimensions were assessed. In BAV patients, 4D flow CMR was repeated after 3 years of follow-up and both at baseline and follow-up computed tomography angiography (CTA) were acquired. Aortic growth (volume increase of ≥5%) was measured on CTA. Regional WSS differences within patients’ aorta and WSS changes over time were analyzed using linear mixed-effect models and were associated with clinical parameters. Results: Thirty BAV patients (aged 34 years [interquartile range (IQR) 25–41]) were included in the follow-up analysis. Additionally, another 16 BAV patients and 32 healthy controls (aged 33 years [IQR 28–48]) were included for other regional analyses. Magnitude, axial, and circumferential WSS increased over time (all p < 0.001) irrespective of aortic growth. The percentage of regions exposed to a magnitude WSS >95th percentile of healthy controls increased from 21% (baseline 506/2400 regions) to 31% (follow-up 734/2400 regions) (p < 0.001). WSS angle, a measure of helicity near the aortic wall, decreased during follow-up. Magnitude WSS changes over time were associated with systolic blood pressure, peak aortic valve velocity, aortic valve regurgitation fraction, aortic stiffness indexes, and normalized flow displacement (all p < 0.05). Conclusion: An increase in regional WSS over time was observed in BAV patients, irrespective of aortic growth. The increasing WSSs, comprising a larger area of the aorta, warrant further research to investigate the possible predictive value for aortic dissection.
UR - http://www.scopus.com/inward/record.url?scp=85204153818&partnerID=8YFLogxK
U2 - 10.1016/j.jocmr.2024.101070
DO - 10.1016/j.jocmr.2024.101070
M3 - Article
C2 - 39096969
SN - 1097-6647
VL - 26
JO - Journal of Cardiovascular Magnetic Resonance
JF - Journal of Cardiovascular Magnetic Resonance
IS - 2
M1 - 101070
ER -