Author + information
- Amartya Kundu,
- Renee Dallasen,
- Adedotun Ogunsua,
- Suvasini Lakshmanan,
- Nikhil Shah,
- John Dickey,
- Bryon Gentile,
- Matthew Parker and
- Linda Pape
Background: Progression of aortic stenosis (AS) in bicuspid aortic valve (BAV) patients is not well understood.
Methods: To investigate which factors in BAV patients predict progression of AS more rapid than the reported average rate of 0.1 cm2/ yr, clinical records and echocardiograms of 260 BAV patients with at least 2 studies, >1 year apart, were reviewed. BAV morphology was confirmed as anterior-posterior or right-left configuration. AS was characterized using Doppler peak velocity, mean gradient, and continuity equation aortic valve area (AVA). Patients with an average decrease in AVA >0.1 cm/yr were considered rapid progressors (n=79) and others were non-rapid progressors (n=181).
Results: Majority of patients (78 %) had no or mild AS. Initial AVA for the entire group was 2.13 +/- 0.9 cm2. Rapid progressors were older, had larger AVA at baseline, greater LV mass indices and were more likely to have moderate to severe aortic regurgitation (AR). They were also more likely to have a history of hypertension and hyperlipidemia, and receive statins and beta blockers. Anterior-posterior orientation of cusp morphology was not associated with rapid progression of AS. By multivariable logistic regression, only hypertension (odds ratio [OR] 1.71), statin use (OR 1.96), and LV mass index (OR 1.01) were associated with rapid progression.
Conclusions: BAV morphology is not associated with progression of aortic stenosis. Hypertension and statin use may modulate progression of AS in BAV patients.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Valvular Heart Disease: Aortic Stenosis
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1233-031
- 2017 American College of Cardiology Foundation