Three-dimensional transoesophageal echocardiography of the aortic valve and root: changes in aortic root dilation and aortic regurgitation
| Autor: | Michel I.M. Versteegh, Madelien V. Regeer, Nina Ajmone Marsan, Victoria Delgado, Vasileios Kamperidis, Martin J. Schalij, Jeroen J. Bax |
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| Rok vydání: | 2016 |
| Předmět: |
aortic root dilation
Male Aortic valve 030204 cardiovascular system & hematology Severity of Illness Index 0302 clinical medicine Bicuspid aortic valve Reference Values Eccentric Prospective Studies 030212 general & internal medicine Netherlands Observer Variation Sinotubular Junction 3DTEE Age Factors General Medicine Middle Aged medicine.anatomical_structure Echocardiography cardiovascular system Cardiology Female Tricuspid Valve Cardiology and Cardiovascular Medicine Aortic root dilation Dilatation Pathologic medicine.medical_specialty Aortic Valve Insufficiency Transoesophageal echocardiography Risk Assessment Statistics Nonparametric 03 medical and health sciences Sex Factors stomatognathic system Internal medicine Confidence Intervals medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Aged business.industry aortic cusp remodelling medicine.disease Confidence interval Case-Control Studies Dilation (morphology) business Echocardiography Transesophageal |
| Zdroj: | European Heart Journal-Cardiovascular Imaging, 18(9), 1041-1048 |
| ISSN: | 2047-2412 2047-2404 |
| Popis: | Aims It has been hypothesized that in response to dilation of the aortic root, the aortic valve cusps may remodel to prevent aortic regurgitation (AR). The aim of the present study was to evaluate the association between aortic cusp dimensions and aortic root geometry. Methods and results Three-dimensional transoesophageal echocardiography was performed in 40 patients with aortic root dilation (mean age 57 ± 12 years, 75% men, 35% bicuspid aortic valve) and 20 controls with a normal aortic root (mean age 61 ± 13 years, 65% men). Aortic valve geometry was measured, and the ratio between closed cusp area and sinotubular junction (STJ) area as a measure of the aortic cusp remodelling relative to the aortic root dilation was assessed. Patients with aortic root dilation with tricuspid aortic valve ( n = 26) showed significant increase in aortic cusp size. However, the closed cusp area to STJ area ratio was smaller in dilated aortic roots [0.88 (95% confidence interval: 0.78–0.98)] compared with normal aortic roots [1.22 (95% confidence interval: 1.02–1.41); P = 0.002]. In addition, in patients with central AR, there was insufficient cusp tissue, as suggested by a closed cusp area to STJ area ratio of 0.75 (95% confidence interval: 0.67–0.82), compared with relative excess of cusp tissue in eccentric AR with a ratio of 1.14 (95% confidence interval: 1.01–1.27; P < 0.001). Conclusion Aortic root dilation was associated with significant increase in aortic valve cusp size. However, this increase seemed insufficient to match aortic root size, particularly in central AR, whereas in eccentric AR, there was relative abundance of cusp tissue resulting in relative cusp prolapse. |
| Databáze: | OpenAIRE |
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