Prevalence and predictors of intracranial aneurysms in patients with bicuspid aortic valve

Alexander Egbe, Ratnasari Padang, Robert D Jr. Brown, Arooj R. Khan, S. Allen Luis, John III Huston, Emmanuel Akintoye, Heidi M. Connolly

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: To determine the prevalence and outcomes of intracranial aneurysm (IA) in patients with bicuspid aortic valve (BAV)Methods: Retrospective review of patients with BAV who underwent brain MR angiography at the Mayo Clinic from 1994 to 2013.Results: There were 678 patients included in this study-mean age 57±13 years, men 480 (71%), mean follow-up 10±3 years (5913 patient-years). Coarctation of aorta (COA) was present in 154 (23%) patients.There were 59 IAs identified in 52 of 678 patients (7.7%). IA was present in 20/154 patients (12.9%) with COA and 32/524 patients (5.7%) without COA (p<0.001). For the patients without COA, female gender and right-left cusp fusion were risks factors for IA in women after adjustment for all potential variables (HR 1.76, CI 1.31 to 2.68, p=0.03). There was no significant trend in the risk for IA across age tertiles: age ≤40 years versus 41-60 years (HR 1.19, p=0.34), and age 41-60 year versus 61-80 years (HR 1.06, p=0.56).Among the 52 patients with IA, enlargement occurred in three patients (6%), rupture in two patients (4%) and four patients (8%) underwent coil embolisation. For the 626 patients without IA at baseline, no patient developed IA over 7±2 years of imaging follow-up.Conclusions: BAV is associated with a higher prevalence of IA compared to the general population, and this risk is higher in patients with COA, right-left cusp fusion and female gender.

Original languageEnglish (US)
JournalHeart
DOIs
StateAccepted/In press - Jun 6 2017

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Intracranial Aneurysm
Aortic Coarctation
Bicuspid Aortic Valve

Keywords

  • Bicuspid aortic valve
  • Coarctation of aorta
  • Intracranial aneurysm
  • Magnetic resonance angiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prevalence and predictors of intracranial aneurysms in patients with bicuspid aortic valve. / Egbe, Alexander; Padang, Ratnasari; Brown, Robert D Jr.; Khan, Arooj R.; Luis, S. Allen; Huston, John III; Akintoye, Emmanuel; Connolly, Heidi M.

In: Heart, 06.06.2017.

Research output: Contribution to journalArticle

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abstract = "Objective: To determine the prevalence and outcomes of intracranial aneurysm (IA) in patients with bicuspid aortic valve (BAV)Methods: Retrospective review of patients with BAV who underwent brain MR angiography at the Mayo Clinic from 1994 to 2013.Results: There were 678 patients included in this study-mean age 57±13 years, men 480 (71{\%}), mean follow-up 10±3 years (5913 patient-years). Coarctation of aorta (COA) was present in 154 (23{\%}) patients.There were 59 IAs identified in 52 of 678 patients (7.7{\%}). IA was present in 20/154 patients (12.9{\%}) with COA and 32/524 patients (5.7{\%}) without COA (p<0.001). For the patients without COA, female gender and right-left cusp fusion were risks factors for IA in women after adjustment for all potential variables (HR 1.76, CI 1.31 to 2.68, p=0.03). There was no significant trend in the risk for IA across age tertiles: age ≤40 years versus 41-60 years (HR 1.19, p=0.34), and age 41-60 year versus 61-80 years (HR 1.06, p=0.56).Among the 52 patients with IA, enlargement occurred in three patients (6{\%}), rupture in two patients (4{\%}) and four patients (8{\%}) underwent coil embolisation. For the 626 patients without IA at baseline, no patient developed IA over 7±2 years of imaging follow-up.Conclusions: BAV is associated with a higher prevalence of IA compared to the general population, and this risk is higher in patients with COA, right-left cusp fusion and female gender.",
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T1 - Prevalence and predictors of intracranial aneurysms in patients with bicuspid aortic valve

AU - Egbe, Alexander

AU - Padang, Ratnasari

AU - Brown, Robert D Jr.

AU - Khan, Arooj R.

AU - Luis, S. Allen

AU - Huston, John III

AU - Akintoye, Emmanuel

AU - Connolly, Heidi M.

PY - 2017/6/6

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N2 - Objective: To determine the prevalence and outcomes of intracranial aneurysm (IA) in patients with bicuspid aortic valve (BAV)Methods: Retrospective review of patients with BAV who underwent brain MR angiography at the Mayo Clinic from 1994 to 2013.Results: There were 678 patients included in this study-mean age 57±13 years, men 480 (71%), mean follow-up 10±3 years (5913 patient-years). Coarctation of aorta (COA) was present in 154 (23%) patients.There were 59 IAs identified in 52 of 678 patients (7.7%). IA was present in 20/154 patients (12.9%) with COA and 32/524 patients (5.7%) without COA (p<0.001). For the patients without COA, female gender and right-left cusp fusion were risks factors for IA in women after adjustment for all potential variables (HR 1.76, CI 1.31 to 2.68, p=0.03). There was no significant trend in the risk for IA across age tertiles: age ≤40 years versus 41-60 years (HR 1.19, p=0.34), and age 41-60 year versus 61-80 years (HR 1.06, p=0.56).Among the 52 patients with IA, enlargement occurred in three patients (6%), rupture in two patients (4%) and four patients (8%) underwent coil embolisation. For the 626 patients without IA at baseline, no patient developed IA over 7±2 years of imaging follow-up.Conclusions: BAV is associated with a higher prevalence of IA compared to the general population, and this risk is higher in patients with COA, right-left cusp fusion and female gender.

AB - Objective: To determine the prevalence and outcomes of intracranial aneurysm (IA) in patients with bicuspid aortic valve (BAV)Methods: Retrospective review of patients with BAV who underwent brain MR angiography at the Mayo Clinic from 1994 to 2013.Results: There were 678 patients included in this study-mean age 57±13 years, men 480 (71%), mean follow-up 10±3 years (5913 patient-years). Coarctation of aorta (COA) was present in 154 (23%) patients.There were 59 IAs identified in 52 of 678 patients (7.7%). IA was present in 20/154 patients (12.9%) with COA and 32/524 patients (5.7%) without COA (p<0.001). For the patients without COA, female gender and right-left cusp fusion were risks factors for IA in women after adjustment for all potential variables (HR 1.76, CI 1.31 to 2.68, p=0.03). There was no significant trend in the risk for IA across age tertiles: age ≤40 years versus 41-60 years (HR 1.19, p=0.34), and age 41-60 year versus 61-80 years (HR 1.06, p=0.56).Among the 52 patients with IA, enlargement occurred in three patients (6%), rupture in two patients (4%) and four patients (8%) underwent coil embolisation. For the 626 patients without IA at baseline, no patient developed IA over 7±2 years of imaging follow-up.Conclusions: BAV is associated with a higher prevalence of IA compared to the general population, and this risk is higher in patients with COA, right-left cusp fusion and female gender.

KW - Bicuspid aortic valve

KW - Coarctation of aorta

KW - Intracranial aneurysm

KW - Magnetic resonance angiography

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