The bicuspid aortic valve: an integrated phenotypic classification of leaflet morphology and aortic root shape
The bicuspid aortic valve: an integrated phenotypic classification of leaflet morphology and aortic root shape
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DOI：
10.1136/hrt.2007.132092
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发表时间：
2008-12-01
期刊：
影响因子：
5.7
通讯作者：
Otto, C. M.
中科院分区：
文献类型：
--
作者：
Schaefer, B. M.;Lewin, M. B.;Otto, C. M.
目的：建立包括瓣叶形态和主动脉形态的二尖瓣分型。单位：西雅图华盛顿大学两个学术医学中心。患者：191例成人BAV患者。干预：回顾临床资料和经胸超声心动图。主要观察指标：评价瓣叶形态；瓣膜功能；主动脉形态和内径。结果：我们确定了三种形态：1型，右冠状动脉和左冠状动脉尖融合(n=152)；2型，右冠状动脉和非冠状动脉融合(n=39)；和3型，左冠状动脉和非冠状动脉融合(n=1)。1型和2型BAV在年龄、身高、体重、血压和主动脉瓣功能方面无显著差异。1型在男性中更常见(69%对45%)。型1的主动脉窦较大，而型2的弓形较大。粘液瘤二尖瓣在2型BAV中更为常见(13%vs2.6%，p<；0.05)。定义三种主动脉形态：正常(N)、窦性消退(E)和升行扩张(A)。比较1型和2型BAV，N型在1型中更常见(60%比32%)，A型在2型中更常见(35%比54%)，E型很少见(P<；0.01在所有组中)。结论：一个全面的BAV型包括主动脉形态。1型BAV与男性和正常的主动脉形态有关，但窦内径较大。2型瓣叶形态与升主动脉扩张、较大的弓尺寸和较高的粘液瘤性二尖瓣疾病的患病率有关。
Objective: To establish a classification of bicuspid aortic valve (BAV) that includes both leaflet morphology and aortic shape.Setting: Two academic medical centres of the University of Washington, Seattle.Patients: 191 adult patients with BAV.Interventions: Review of clinical data and transthoracic echocardiograms.Main outcome measures: Assessment of leaflet morphology; valve function; aortic shape and dimensions.Results: We identified three morphologies: type 1, fusion of right and left coronary cusp (n = 152); type 2, right and non- coronary fusion (n = 39); and type 3, left and noncoronary fusion (n = 1). Comparing type 1 and 2 BAV, there were no significant differences in age, height, weight, blood pressure or aortic valve function. Type 1 was more common in men (69 vs 45%). The aortic sinuses were larger in type 1, while type 2 had larger arch dimensions. Myxomatous mitral valves were more common in type 2 BAV (13% vs 2.6%, p < 0.05). Three aortic shapes were defined: normal (N), sinus effacement (E), and ascending dilatation (A). Comparing type 1 to type 2 BAV, shape N was more common in type 1 (60% vs 32%), and type A was more common in type 2 (35% vs 54%,); type E was rare (p < 0.01 across all groups).Conclusion: A comprehensive BAV phenotype includes aortic shape. Type 1 BAV is associated with male gender and normal aortic shape but a larger sinus diameter. Type 2 leaflet morphology is associated with ascending aorta dilatation, larger arch dimensions and higher prevalence of myxomatous mitral valve disease.