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Aortic Cross-Sectional Area/Height Ratio and Outcomes in Patients With Bicuspid Aortic Valve and a Dilated Ascending Aorta.
- Source :
-
Circulation. Cardiovascular imaging [Circ Cardiovasc Imaging] 2017 Jun; Vol. 10 (6), pp. e006249. - Publication Year :
- 2017
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Abstract
- Background: In patients with bicuspid aortic valve and dilated proximal ascending aorta, we sought to assess (1) factors associated with increased longer-term cardiovascular mortality and (2) incremental prognostic use of indexing aortic root to patient height.<br />Methods and Results: We studied 969 consecutive bicuspid aortic valve patients (50±13 years; 87% men) with proximal aorta ≥4 cm, who also had a gated contrast-enhanced thoracic computed tomography or magnetic resonance angiography. A ratio of ascending aortic area/height was calculated on tomography, and ≥10 cm <superscript>2</superscript> /m was considered abnormal, as previously reported. Society of Thoracic Surgeons score and cardiovascular death were recorded. Greater than or equal to III+ aortic regurgitation and severe aortic stenosis were seen in 37% and 10%, respectively. Society of Thoracic Surgeons score and right ventricular systolic pressure were 2±3 and 15±16 mm Hg, respectively. Abnormal ascending aortic area/height ratio was noted in 33%; 44% underwent ascending aortic surgery at 34 days. At 10.8 years (interquartile range, 9.6-12.3), 82 (9%) died (0.4% in-hospital postoperative mortality). On multivariable Cox survival analysis, ascending aortic area/height ratio (hazard ratio, 2; 95% confidence interval, 1.20-3.35) was associated with cardiovascular death, whereas aortic surgery (hazard ratio, 0.46; confidence interval, 0.26-0.80) was associated with improved survival (both P <0.01). Of the 405 patients with ascending aortic diameter of 4.5 to 5.5 cm, 64% had an abnormal ascending aortic area/height ratio, and 70% deaths occurred in patients with an abnormal ratio.<br />Conclusions: In bicuspid aortic valve patients with dilated proximal ascending aorta, ascending aortic area/height ratio was independently associated with cardiovascular death.<br /> (© 2017 American Heart Association, Inc.)
- Subjects :
- Adult
Anatomic Landmarks
Aorta pathology
Aorta surgery
Aortic Aneurysm mortality
Aortic Aneurysm pathology
Aortic Aneurysm surgery
Aortic Valve diagnostic imaging
Aortic Valve surgery
Bicuspid Aortic Valve Disease
Cause of Death
Chi-Square Distribution
Dilatation, Pathologic
Female
Heart Valve Diseases mortality
Heart Valve Diseases surgery
Hospital Mortality
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Ohio
Predictive Value of Tests
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Aorta diagnostic imaging
Aortic Aneurysm diagnostic imaging
Aortic Valve abnormalities
Aortography methods
Computed Tomography Angiography
Heart Valve Diseases diagnostic imaging
Magnetic Resonance Angiography
Multidetector Computed Tomography
Subjects
Details
- Language :
- English
- ISSN :
- 1942-0080
- Volume :
- 10
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Circulation. Cardiovascular imaging
- Publication Type :
- Academic Journal
- Accession number :
- 28592593
- Full Text :
- https://doi.org/10.1161/CIRCIMAGING.116.006249