TY - JOUR
T1 - Comparative study of bicuspid vs. tricuspid aortic valve stenosis
AU - Huntley, Geoffrey D.
AU - Thaden, Jeremy J.
AU - Alsidawi, Said
AU - Michelena, Hector I.
AU - Maleszewski, Joseph J.
AU - Edwards, William D.
AU - Scott, Christopher G.
AU - Pislaru, Sorin V.
AU - Pellikka, Patricia A.
AU - Greason, Kevin L.
AU - Ammash, Naser M.
AU - Malouf, Joseph F.
AU - Enriquez-Sarano, Maurice
AU - Nkomo, Vuyisile T.
N1 - Publisher Copyright:
© The Author 2017. For permissions, please email: journals.permissions@oup.com.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Aims To examine differences and similarities in bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) stenosis occurring during the same age and whether any differences impact outcomes following aortic valve replacement (AVR). Methods and results An age-matched cohort of 198 BAV stenosis and 198 TAV stenosis patients was identified from 888 consecutive patients undergoing AVR for severe AS. Mean age 68 ± 6 years; 68% male. Patients with BAV were less likely to have multiple comorbidities, as measured by the Charlson Comorbidity Index (CCI) >2 (3 vs. 10%, P = 0.007). Indexed aortic valve area (0.44 ± 0.09 vs. 0.42 ± 0.08 cm 2 /m 2, P = 0.17) and left ventricular ejection fraction (LVEF) were similar (62 ± 11 vs. 61 ± 12%, P = 0.12), but E/e' ≥15 (46 vs. 66%, P = 0.0002) was less common in BAV stenosis. A tissue aortic valve prosthesis was more commonly utilized in both groups (81 vs. 78%, P = 0.54). Overall indexed effective orifice area was larger in BAV compared with TAV (1.08 ± 0.33 vs. 0.96 ± 0.25 cm 2 /m 2, P = 0.0008). Five-year survival following AVR was lower in TAV compared with BAV stenosis (61 vs. 79%, P = 0.02). Independent predictors of survival following AVR were LVEF < 50% [hazard ratio (HR): 4.8, P = 0.0005], CCI > 2 (HR: 3.1, P = 0.015), effective orifice area index ≤0.85 cm 2 /m 2 (HR: 2.5, P = 0.004), and bioprosthesis (HR: 3.7, P = 0.02). Conclusion In an age-matched cohort, TAV compared with BAV stenosis is associated with greater prevalence of cardiovascular risk factors and cardiac impairment and worse survival after AVR. Published on behalf of the European Society of Cardiology. All rights reserved.
AB - Aims To examine differences and similarities in bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) stenosis occurring during the same age and whether any differences impact outcomes following aortic valve replacement (AVR). Methods and results An age-matched cohort of 198 BAV stenosis and 198 TAV stenosis patients was identified from 888 consecutive patients undergoing AVR for severe AS. Mean age 68 ± 6 years; 68% male. Patients with BAV were less likely to have multiple comorbidities, as measured by the Charlson Comorbidity Index (CCI) >2 (3 vs. 10%, P = 0.007). Indexed aortic valve area (0.44 ± 0.09 vs. 0.42 ± 0.08 cm 2 /m 2, P = 0.17) and left ventricular ejection fraction (LVEF) were similar (62 ± 11 vs. 61 ± 12%, P = 0.12), but E/e' ≥15 (46 vs. 66%, P = 0.0002) was less common in BAV stenosis. A tissue aortic valve prosthesis was more commonly utilized in both groups (81 vs. 78%, P = 0.54). Overall indexed effective orifice area was larger in BAV compared with TAV (1.08 ± 0.33 vs. 0.96 ± 0.25 cm 2 /m 2, P = 0.0008). Five-year survival following AVR was lower in TAV compared with BAV stenosis (61 vs. 79%, P = 0.02). Independent predictors of survival following AVR were LVEF < 50% [hazard ratio (HR): 4.8, P = 0.0005], CCI > 2 (HR: 3.1, P = 0.015), effective orifice area index ≤0.85 cm 2 /m 2 (HR: 2.5, P = 0.004), and bioprosthesis (HR: 3.7, P = 0.02). Conclusion In an age-matched cohort, TAV compared with BAV stenosis is associated with greater prevalence of cardiovascular risk factors and cardiac impairment and worse survival after AVR. Published on behalf of the European Society of Cardiology. All rights reserved.
KW - aortic stenosis
KW - aortic valve replacement
KW - bicuspid aortic valve
KW - comorbidities
UR - http://www.scopus.com/inward/record.url?scp=85040048151&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85040048151&partnerID=8YFLogxK
U2 - 10.1093/ehjci/jex211
DO - 10.1093/ehjci/jex211
M3 - Article
C2 - 29029001
AN - SCOPUS:85040048151
SN - 2047-2404
VL - 19
SP - 3
EP - 8
JO - European heart journal cardiovascular Imaging
JF - European heart journal cardiovascular Imaging
IS - 1
ER -