TY - JOUR
T1 - Low and Oscillatory Wall Shear Stress Is Not Related to Aortic Dilation in Patients With Bicuspid Aortic Valve
AU - Dux-Santoy, Lydia
AU - Guala, Andrea
AU - Sotelo, Julio
AU - Uribe, Sergio
AU - Teixido-Tura, Gisela
AU - Ruiz-Muñoz, Aroa
AU - Hurtado, Daniel E.
AU - Valente, Filipa
AU - Galian-Gay, Laura
AU - Gutiérrez García-Moreno, Laura
AU - González-Alujas, Teresa
AU - Johnson, Kevin M.
AU - Wieben, Oliver
AU - Ferreira-Gonzalez, Ignacio
AU - Evangelista Masip, Arturo
AU - Rodriguez-Palomares, Jose F
PY - 2019
Y1 - 2019
N2 - 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.
AB - 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.
KW - Aorta
KW - Bicuspid aortic valve
KW - Magnetic resonance imaging
KW - Mechanical stress
KW - Regional blood flow
KW - Thoracic aortic aneurysm
KW - Vascular remodeling
U2 - 10.1161/ATVBAHA.119.313636
DO - 10.1161/ATVBAHA.119.313636
M3 - Article
C2 - 31801375
SN - 1049-8834
VL - 40
SP - e10-e20
JO - Arteriosclerosis and Thrombosis
JF - Arteriosclerosis and Thrombosis
ER -