Abstract
In patients with bicuspid aortic valve (BAV), beta-blockers (BB) are assumed to slow ascending aorta (AAo) dilation by reducing wall shear stress (WSS) on the aneurysmal segment. The aim of this study was to assess differences in AAo peak velocity and WSS in BAV patients with and without BB therapy. BAV patients receiving BB (BB+, n = 30, age: 47 ± 11 years) or not on BB (BB−, n = 30, age: 46 ± 13 years) and healthy controls (n = 15, age: 43 ± 11 years) underwent 4D flow MRI for the assessment of in vivo aortic 3D blood flow. Peak systolic velocities and 3D WSS were calculated at the anterior and posterior walls of the AAo. Both patient groups had higher maximum and mean WSS relative to the control group (p = 0.001 to p = 0.04). WSS was not reduced in the BB+ group compared to BB− patients in the anterior AAo (maximum: 1.49 ± 0.47 vs. 1.38 ± 0.49 N/m2, p = 0.99, mean: 0.76 ± 0.2 vs. 0.74 ± 0.18 N/m2, p = 1.00) or posterior AAo (maximum: 1.45 ± 0.42 vs. 1.39 ± 0.58 N/m2, p = 1.00; mean: 0.65 ± 0.16 vs. 0.63 ± 0.16 N/m2, p = 1.00). AAo peak velocity was elevated in patients compared to controls (p < 0.01) but similar for BB+ and BB− groups (p = 0.42). Linear models identified significant relationships between aortic stenosis severity and increased maximum WSS (β = 0.186, p = 0.007) and between diameter at the sinus of Valsalva and reduced mean WSS (β = −0.151, p = 0.045). Peak velocity and systolic WSS were similar for BAV patients irrespective of BB therapy. Further prospective studies are needed to investigate the impact of dosage and duration of BB therapy on aortic hemodynamics and development of aortopathy.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 621-628 |
| Number of pages | 8 |
| Journal | International Journal of Cardiovascular Imaging |
| Volume | 32 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 1 2016 |
Fingerprint
Keywords
- 4D flow MRI
- Aortic dilatation
- Beta blocker
- Bicuspid aortic valve
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine
Cite this
}
Influence of beta-blocker therapy on aortic blood flow in patients with bicuspid aortic valve. / Allen, Bradley D.; Markl, Michael; Barker, Alex J; van Ooij, Pim; Carr, James; Malaisrie, S Chris; McCarthy, Patrick M; Bonow, Robert O; Kansal, Preeti.
In: International Journal of Cardiovascular Imaging, Vol. 32, No. 4, 01.04.2016, p. 621-628.Research output: Contribution to journal › Article
TY - JOUR
T1 - Influence of beta-blocker therapy on aortic blood flow in patients with bicuspid aortic valve
AU - Allen, Bradley D.
AU - Markl, Michael
AU - Barker, Alex J
AU - van Ooij, Pim
AU - Carr, James
AU - Malaisrie, S Chris
AU - McCarthy, Patrick M
AU - Bonow, Robert O
AU - Kansal, Preeti
PY - 2016/4/1
Y1 - 2016/4/1
N2 - In patients with bicuspid aortic valve (BAV), beta-blockers (BB) are assumed to slow ascending aorta (AAo) dilation by reducing wall shear stress (WSS) on the aneurysmal segment. The aim of this study was to assess differences in AAo peak velocity and WSS in BAV patients with and without BB therapy. BAV patients receiving BB (BB+, n = 30, age: 47 ± 11 years) or not on BB (BB−, n = 30, age: 46 ± 13 years) and healthy controls (n = 15, age: 43 ± 11 years) underwent 4D flow MRI for the assessment of in vivo aortic 3D blood flow. Peak systolic velocities and 3D WSS were calculated at the anterior and posterior walls of the AAo. Both patient groups had higher maximum and mean WSS relative to the control group (p = 0.001 to p = 0.04). WSS was not reduced in the BB+ group compared to BB− patients in the anterior AAo (maximum: 1.49 ± 0.47 vs. 1.38 ± 0.49 N/m2, p = 0.99, mean: 0.76 ± 0.2 vs. 0.74 ± 0.18 N/m2, p = 1.00) or posterior AAo (maximum: 1.45 ± 0.42 vs. 1.39 ± 0.58 N/m2, p = 1.00; mean: 0.65 ± 0.16 vs. 0.63 ± 0.16 N/m2, p = 1.00). AAo peak velocity was elevated in patients compared to controls (p < 0.01) but similar for BB+ and BB− groups (p = 0.42). Linear models identified significant relationships between aortic stenosis severity and increased maximum WSS (β = 0.186, p = 0.007) and between diameter at the sinus of Valsalva and reduced mean WSS (β = −0.151, p = 0.045). Peak velocity and systolic WSS were similar for BAV patients irrespective of BB therapy. Further prospective studies are needed to investigate the impact of dosage and duration of BB therapy on aortic hemodynamics and development of aortopathy.
AB - In patients with bicuspid aortic valve (BAV), beta-blockers (BB) are assumed to slow ascending aorta (AAo) dilation by reducing wall shear stress (WSS) on the aneurysmal segment. The aim of this study was to assess differences in AAo peak velocity and WSS in BAV patients with and without BB therapy. BAV patients receiving BB (BB+, n = 30, age: 47 ± 11 years) or not on BB (BB−, n = 30, age: 46 ± 13 years) and healthy controls (n = 15, age: 43 ± 11 years) underwent 4D flow MRI for the assessment of in vivo aortic 3D blood flow. Peak systolic velocities and 3D WSS were calculated at the anterior and posterior walls of the AAo. Both patient groups had higher maximum and mean WSS relative to the control group (p = 0.001 to p = 0.04). WSS was not reduced in the BB+ group compared to BB− patients in the anterior AAo (maximum: 1.49 ± 0.47 vs. 1.38 ± 0.49 N/m2, p = 0.99, mean: 0.76 ± 0.2 vs. 0.74 ± 0.18 N/m2, p = 1.00) or posterior AAo (maximum: 1.45 ± 0.42 vs. 1.39 ± 0.58 N/m2, p = 1.00; mean: 0.65 ± 0.16 vs. 0.63 ± 0.16 N/m2, p = 1.00). AAo peak velocity was elevated in patients compared to controls (p < 0.01) but similar for BB+ and BB− groups (p = 0.42). Linear models identified significant relationships between aortic stenosis severity and increased maximum WSS (β = 0.186, p = 0.007) and between diameter at the sinus of Valsalva and reduced mean WSS (β = −0.151, p = 0.045). Peak velocity and systolic WSS were similar for BAV patients irrespective of BB therapy. Further prospective studies are needed to investigate the impact of dosage and duration of BB therapy on aortic hemodynamics and development of aortopathy.
KW - 4D flow MRI
KW - Aortic dilatation
KW - Beta blocker
KW - Bicuspid aortic valve
UR - http://www.scopus.com/inward/record.url?scp=84955586459&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84955586459&partnerID=8YFLogxK
U2 - 10.1007/s10554-015-0819-3
DO - 10.1007/s10554-015-0819-3
M3 - Article
C2 - 26817758
AN - SCOPUS:84955586459
VL - 32
SP - 621
EP - 628
JO - International Journal of Cardiovascular Imaging
JF - International Journal of Cardiovascular Imaging
SN - 1569-5794
IS - 4
ER -