Low and Oscillatory Wall Shear Stress Is Not Related to Aortic Dilation in Patients With Bicuspid Aortic Valve
Dux-Santoy, Lydia (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Guala, Andrea (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Sotelo, Julio (Pontificia Universidad Católica de Chile)
Uribe, Sergio (Pontificia Universidad Católica de Chile)
Teixido-Tura, Gisela (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Ruiz-Muñoz, Aroa (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Hurtado, Daniel E. (Pontificia Universidad Católica de Chile)
Valente, Filipa (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Galian-Gay, Laura (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Gutiérrez García-Moreno, Laura (Hospital Universitari Vall d'Hebron. Institut de Recerca)
González-Alujas, Teresa (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Johnson, Kevin M. (University of Wisconsin-Madison)
Wieben, Oliver (University of Wisconsin-Madison)
Ferreira-Gonzalez, Ignacio (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Evangelista Masip, Arturo (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rodriguez-Palomares, Jose F (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Universitat Autònoma de Barcelona

Date:	2019
Abstract:	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.
Grants:	Ministerio de Economía y Competitividad RTC-2016-5152-1 Instituto de Salud Carlos III PI14/0106 Instituto de Salud Carlos III PI17/00381
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Aorta ; Bicuspid aortic valve ; Magnetic resonance imaging ; Mechanical stress ; Regional blood flow ; Thoracic aortic aneurysm ; Vascular remodeling
Published in:	Arteriosclerosis, Thrombosis, and Vascular Biology, Vol. 40 (december 2019) , p. e10-e20, ISSN 1524-4636

DOI: 10.1161/ATVBAHA.119.313636
PMID: 31801375

11 p, 2.1 MB

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