Misclassification of bicuspid aortic valves is common and varies by imaging modality and patient characteristics.
Misclassification of bicuspid aortic valves is common and varies by imaging modality and patient characteristics.
复制标题
二叶式主动脉瓣的错误分类很常见，并且因成像方式和患者特征而异。
DOI：
10.1111/echo.14295
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Prakash,SiddharthK
中科院分区：
文献类型：
--
作者：
Cramer,PeytonM;Prakash,SiddharthK
BackgroundBicuspid aortic valve (BAV) is the most prevalent adult congenital heart defect. BAV causes lifelong progressive disease that can be prevented by early diagnosis and long‐term surveillance, but may be compromised by misclassification of valve morphology.MethodsThe study population was derived from the UTHealth Bicuspid Aortic Valve Registry, which includes serial images on more than 200 participants over a mean follow‐up interval of 2.8 years. We abstracted descriptions of aortic valve morphology from transthoracic or transesophageal echocardiography, computed tomography angiography, and magnetic resonance angiography reports. We used chi‐square and t tests to determine associations between reported valve morphologies (definitely bicuspid, possibly bicuspid, tricuspid, or uncertain) and clinical characteristics and assessed image quality using a validated tool.ResultsAbout 40% of participants were misclassified in at least one imaging report. The mean interval between misclassification and correct diagnosis was 22 months. TEE, MR and CT were more sensitive than TTE and successfully reclassified 20% of participants, but were only used in 14% of patients. Misclassification was associated with age, the extent of valve calcification and image quality, but was not significantly associated with aortic regurgitation, gender, or cusp configuration.ConclusionMisclassification of BAV is prevalent, frequently leads to delayed diagnosis, and is more likely to occur in the most severely affected cases. TEE, CT and MR may increase diagnostic accuracy in up to half of BAV cases but are underutilized. Additional studies are needed to determine if misclassification of BAV patients leads to increased long‐term morbidity and mortality.
