Valve disease and aortopathy associations of bicuspid aortic valve phenotypes differ between men and women
Objective Determine whether associations between bicuspid aortic valve (BAV) phenotypes, valve disease and aortopathy differ between sexes.Methods 1045 patients with BAV (76.0% men, n=794) from two surgical centres were included in this cross-sectional study. Valve phenotype was classified intraoper...
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BMJ Publishing Group
2021-12-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/8/2/e001857.full |
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| author | Anders Franco-Cereceda Luc Mertens Christian Olsson Carl Granath Salah A Mohamed Michael Grattan Hanna M Björck |
| author_facet | Anders Franco-Cereceda Luc Mertens Christian Olsson Carl Granath Salah A Mohamed Michael Grattan Hanna M Björck |
| author_sort | Anders Franco-Cereceda |
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| description | Objective Determine whether associations between bicuspid aortic valve (BAV) phenotypes, valve disease and aortopathy differ between sexes.Methods 1045 patients with BAV (76.0% men, n=794) from two surgical centres were included in this cross-sectional study. Valve phenotype was classified intraoperatively as right–left (RL), right-non-coronary (RN), left-non-coronary (LN) or 2-sinus BAV. Echocardiography was used to determine type and degree of valve disease, and aortic dimensions. Aortic dilatation was defined as diameter ≥4.5 cm.Results RL was the most common phenotype (73.6%), followed by RN (16.2%), 2-sinus BAV (9.2%) and LN (1.1%), with no difference in phenotype distribution between men and women (p=0.634). Aortic valve insufficiency (AI) prevalence differed significantly with valve phenotype in men (p=0.047), with RL and LN having the highest prevalence (34.1% and 44.0%, respectively). In women, RN had a higher proportion of AI than RL (21.3% vs 7.3%, p=0.017). Men with RL had larger root dimensions, in particular at the sinus (mean difference 0.24 cm compared with RN, p=0.002). Men with 2-sinus BAV had the highest prevalence of root phenotype dilatation (7.0%, other phenotypes ≤2.3%, p=0.031), whereas women with 2-sinus BAV did not have root dilatation and smaller sinus dimensions (mean difference: 0.35 cm compared with RL, p=0.021). Aortic root segments were larger in men with AI compared with aortic stenosis (sinus mean difference: 0.40 cm, p<0.001). The difference was even larger in women (mean difference: 0.78 cm, p<0.001), and women with AI also had larger tubular segments (mean difference: 0.61 cm, p=0.001).Conclusions There are significant sex differences in clinical associations of BAV phenotypes, which should be considered in further studies on the role of phenotypes in individualised patient management. |
| format | Article |
| id | doaj-art-0107710bdda64b4d9235f1e25004eb66 |
| institution | Kabale University |
| issn | 2053-3624 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | BMJ Publishing Group |
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| series | Open Heart |
| spelling | doaj-art-0107710bdda64b4d9235f1e25004eb662024-11-11T15:20:12ZengBMJ Publishing GroupOpen Heart2053-36242021-12-018210.1136/openhrt-2021-001857Valve disease and aortopathy associations of bicuspid aortic valve phenotypes differ between men and womenAnders Franco-Cereceda0Luc Mertens1Christian Olsson2Carl Granath3Salah A Mohamed4Michael Grattan5Hanna M Björck6Department of Molecular Medicine and Surgery, Section of Cardiothoracic Surgery, Karolinska Institutet, Stockholm, SwedenDepartment of Paediatrics, Division of Cardiology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, CanadaDepartment of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, SwedenDepartment of Molecular Medicine and Surgery, Section of Cardiothoracic Surgery, Karolinska Institutet, Stockholm, SwedenDepartment of Cardiac and Thoracic Vascular Surgery, Universitätsklinikum Schleswig-Holstein Campus Lübeck, Lubeck, GermanyDepartment of Paediatrics, LHSC Children`s Hospital, University of Western Ontario, London, Ontario, CanadaCardiovascular Medicine Unit, Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, SwedenObjective Determine whether associations between bicuspid aortic valve (BAV) phenotypes, valve disease and aortopathy differ between sexes.Methods 1045 patients with BAV (76.0% men, n=794) from two surgical centres were included in this cross-sectional study. Valve phenotype was classified intraoperatively as right–left (RL), right-non-coronary (RN), left-non-coronary (LN) or 2-sinus BAV. Echocardiography was used to determine type and degree of valve disease, and aortic dimensions. Aortic dilatation was defined as diameter ≥4.5 cm.Results RL was the most common phenotype (73.6%), followed by RN (16.2%), 2-sinus BAV (9.2%) and LN (1.1%), with no difference in phenotype distribution between men and women (p=0.634). Aortic valve insufficiency (AI) prevalence differed significantly with valve phenotype in men (p=0.047), with RL and LN having the highest prevalence (34.1% and 44.0%, respectively). In women, RN had a higher proportion of AI than RL (21.3% vs 7.3%, p=0.017). Men with RL had larger root dimensions, in particular at the sinus (mean difference 0.24 cm compared with RN, p=0.002). Men with 2-sinus BAV had the highest prevalence of root phenotype dilatation (7.0%, other phenotypes ≤2.3%, p=0.031), whereas women with 2-sinus BAV did not have root dilatation and smaller sinus dimensions (mean difference: 0.35 cm compared with RL, p=0.021). Aortic root segments were larger in men with AI compared with aortic stenosis (sinus mean difference: 0.40 cm, p<0.001). The difference was even larger in women (mean difference: 0.78 cm, p<0.001), and women with AI also had larger tubular segments (mean difference: 0.61 cm, p=0.001).Conclusions There are significant sex differences in clinical associations of BAV phenotypes, which should be considered in further studies on the role of phenotypes in individualised patient management.https://openheart.bmj.com/content/8/2/e001857.full |
| spellingShingle | Anders Franco-Cereceda Luc Mertens Christian Olsson Carl Granath Salah A Mohamed Michael Grattan Hanna M Björck Valve disease and aortopathy associations of bicuspid aortic valve phenotypes differ between men and women Open Heart |
| title | Valve disease and aortopathy associations of bicuspid aortic valve phenotypes differ between men and women |
| title_full | Valve disease and aortopathy associations of bicuspid aortic valve phenotypes differ between men and women |
| title_fullStr | Valve disease and aortopathy associations of bicuspid aortic valve phenotypes differ between men and women |
| title_full_unstemmed | Valve disease and aortopathy associations of bicuspid aortic valve phenotypes differ between men and women |
| title_short | Valve disease and aortopathy associations of bicuspid aortic valve phenotypes differ between men and women |
| title_sort | valve disease and aortopathy associations of bicuspid aortic valve phenotypes differ between men and women |
| url | https://openheart.bmj.com/content/8/2/e001857.full |
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