Regional aortic wall shear stress increases over time in patients with a bicuspid aortic valve
ABSTRACT: 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 underwen...
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Elsevier
2024-01-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1097664724010974 |
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| author | Savine C.S. Minderhoud Aïmane Arrouby Allard T. van den Hoven Lidia R. Bons Raluca G. Chelu Isabella Kardys Dimitris Rizopoulos Suze-Anne Korteland Annemien E. van den Bosch Ricardo P.J. Budde Jolien W. Roos-Hesselink Jolanda J. Wentzel Alexander Hirsch |
| author_facet | Savine C.S. Minderhoud Aïmane Arrouby Allard T. van den Hoven Lidia R. Bons Raluca G. Chelu Isabella Kardys Dimitris Rizopoulos Suze-Anne Korteland Annemien E. van den Bosch Ricardo P.J. Budde Jolien W. Roos-Hesselink Jolanda J. Wentzel Alexander Hirsch |
| author_sort | Savine C.S. Minderhoud |
| collection | DOAJ |
| description | ABSTRACT: 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. |
| format | Article |
| id | doaj-art-e7ea856fc3af498ca8376f1673f85065 |
| institution | DOAJ |
| issn | 1097-6647 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj-art-e7ea856fc3af498ca8376f1673f850652025-08-20T02:49:02ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472024-01-0126210107010.1016/j.jocmr.2024.101070Regional aortic wall shear stress increases over time in patients with a bicuspid aortic valveSavine C.S. Minderhoud0Aïmane Arrouby1Allard T. van den Hoven2Lidia R. Bons3Raluca G. Chelu4Isabella Kardys5Dimitris Rizopoulos6Suze-Anne Korteland7Annemien E. van den Bosch8Ricardo P.J. Budde9Jolien W. Roos-Hesselink10Jolanda J. Wentzel11Alexander Hirsch12Department of Cardiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Cardiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Cardiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Cardiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Cardiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Cardiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Biostatistics, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Cardiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Cardiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Cardiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Cardiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Cardiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Cardiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands; Corresponding author. Department of Cardiology, Erasmus Medical Center, Room Rg-419, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.ABSTRACT: 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.http://www.sciencedirect.com/science/article/pii/S10976647240109744D flow CMRBicuspid aortic valveWall shear stressAortic diseases |
| spellingShingle | Savine C.S. Minderhoud Aïmane Arrouby Allard T. van den Hoven Lidia R. Bons Raluca G. Chelu Isabella Kardys Dimitris Rizopoulos Suze-Anne Korteland Annemien E. van den Bosch Ricardo P.J. Budde Jolien W. Roos-Hesselink Jolanda J. Wentzel Alexander Hirsch Regional aortic wall shear stress increases over time in patients with a bicuspid aortic valve Journal of Cardiovascular Magnetic Resonance 4D flow CMR Bicuspid aortic valve Wall shear stress Aortic diseases |
| title | Regional aortic wall shear stress increases over time in patients with a bicuspid aortic valve |
| title_full | Regional aortic wall shear stress increases over time in patients with a bicuspid aortic valve |
| title_fullStr | Regional aortic wall shear stress increases over time in patients with a bicuspid aortic valve |
| title_full_unstemmed | Regional aortic wall shear stress increases over time in patients with a bicuspid aortic valve |
| title_short | Regional aortic wall shear stress increases over time in patients with a bicuspid aortic valve |
| title_sort | regional aortic wall shear stress increases over time in patients with a bicuspid aortic valve |
| topic | 4D flow CMR Bicuspid aortic valve Wall shear stress Aortic diseases |
| url | http://www.sciencedirect.com/science/article/pii/S1097664724010974 |
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