Prevalence, Characteristics, and Clinical Significance of Concomitant Cardiomyopathies in Subjects with Bicuspid Aortic Valves
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Purpose: The present study aimed to investigate the prevalence, characteristics, and clinical significance of concomitant specificcardiomyopathies in subjects with bicuspid aortic valves (BAVs). Materials and Methods: A total of 1186 adults with BAV (850 males, mean age 56±14 years) at a single tertiary center were comprehensivelyreviewed. Left ventricular non-compaction, hypertrophic cardiomyopathy, and idiopathic dilated cardiomyopathywere confirmed when patients fulfilled current clinical and echocardiographic criteria. Clinical and echocardiographic characteristics,including comorbidities, heart failure presentation, BAV morphology, function, and aorta phenotypes, in BAV subjectswith or without specific cardiomyopathies were compared. Results: Overall, 67 subjects (5.6%) had concomitant cardiomyopathies: 40 (3.4%) patients with left ventricular non-compaction,17 (1.4%) with hypertrophic cardiomyopathy, and 10 (0.8%) with dilated cardiomyopathy. BAV subjects with hypertrophic cardiomyopathyhad higher prevalences of diabetes mellitus and heart failure with preserved ejection fraction, and tended to havetype 0 phenotype, while BAV subjects with dilated cardiomyopathy showed higher prevalences of chronic kidney disease andheart failure with reduced ejection fraction. BAV subjects with left ventricular non-compaction were significantly younger andpredominantly male, and had greater BAV dysfunction and a higher prevalence of normal aorta shape. In multiple regressionanalysis, cardiomyopathy was independently associated with heart failure (odds ratio 2.795, 95% confidential interval 1.603–4.873, p<0.001) after controlling for confounding factors. Conclusion: Concomitant cardiomyopathies were observed in 5.6% of subjects with BAV. A few different clinical and echocardiographiccharacteristics were found. The presence of cardiomyopathy was independently associated with heart failure.
Abstract
Purpose: The present study aimed to investigate the prevalence, characteristics, and clinical significance of concomitant specificcardiomyopathies in subjects with bicuspid aortic valves (BAVs). Materials and Methods: A total of 1186 adults with BAV (850 males, mean age 56±14 years) at a single tertiary center were comprehensivelyreviewed. Left ventricular non-compaction, hypertrophic cardiomyopathy, and idiopathic dilated cardiomyopathywere confirmed when patients fulfilled current clinical and echocardiographic criteria. Clinical and echocardiographic characteristics,including comorbidities, heart failure presentation, BAV morphology, function, and aorta phenotypes, in BAV subjectswith or without specific cardiomyopathies were compared. Results: Overall, 67 subjects (5.6%) had concomitant cardiomyopathies: 40 (3.4%) patients with left ventricular non-compaction,17 (1.4%) with hypertrophic cardiomyopathy, and 10 (0.8%) with dilated cardiomyopathy. BAV subjects with hypertrophic cardiomyopathyhad higher prevalences of diabetes mellitus and heart failure with preserved ejection fraction, and tended to havetype 0 phenotype, while BAV subjects with dilated cardiomyopathy showed higher prevalences of chronic kidney disease andheart failure with reduced ejection fraction. BAV subjects with left ventricular non-compaction were significantly younger andpredominantly male, and had greater BAV dysfunction and a higher prevalence of normal aorta shape. In multiple regressionanalysis, cardiomyopathy was independently associated with heart failure (odds ratio 2.795, 95% confidential interval 1.603–4.873, p<0.001) after controlling for confounding factors. Conclusion: Concomitant cardiomyopathies were observed in 5.6% of subjects with BAV. A few different clinical and echocardiographiccharacteristics were found. The presence of cardiomyopathy was independently associated with heart failure.
참고문헌 (25)
- Ward C, "Clinical significance of the bicuspid aortic valve", Heart, 83, pp.81~85 (2000)
- Prakash SK, "A roadmap to investigate the genetic basis of bicuspid aortic valve and its complications : insights from the international BAVCon(Bicuspid Aortic Valve Consortium)", J Am Coll Cardiol, 64, pp.832~839 (2014)
- Shim CY, "Central aortic stiffness and its association with ascending aorta dilation in subjects with a bicuspid aortic valve", J Am Soc Echocardiogr, 24, pp.847~852 (2011)
- Kim M, "Characteristics of carotid artery structure and mechanical function and their relationships with aortopathy in patients with bicuspid aortic valves", Front Physiol, 8, pp.622~ (2017)
- Niaz T, "Incidence, morphology, and progression of bicuspid aortic valve in pediatric and young adult subjects with coexisting congenital heart defects", Congenit Heart Dis, 12, pp.261~269 (2017)
- Niaz T, "Characteristic morphologies of the bicuspid aortic valve in patients with genetic syndromes", J Am Soc Echocardiogr, 31, pp.194~200 (2018)
- Lee SY, "Association of aortic phenotypes and mechanical function with left ventricular diastolic function in subjects with normally functioning bicuspid aortic valves and comparison to subjects with tricuspid aortic valves", Am J Cardiol, 116, pp.1547~1554 (2015)
- Weismann CG, "Aortic stiffness and left ventricular diastolic function in children with well-functioning bicuspid aortic valves", Eur Heart J Cardiovasc Imaging, 17, pp.225~230 (2016)
- Lee SY, "Determinants and prognostic significance of symptomatic status in patients with moderately dysfunctional bicuspid aortic valves", PLoS One, 12, pp.e0169285~ (2017)
- Feizi O, "Familial study of hypertrophic cardiomyopathy and congenital aortic valve disease", Am J Cardiol, 41, pp.956~964 (1978)
- Brown PS Jr, "Combined obstructive hypertrophic cardiomyopathy and stenotic congenitally bicuspid aortic valve", Am J Cardiol, 66, pp.1273~1275 (1990)
- Agarwal A, "Left ventricular noncompaction in patients with bicuspid aortic valve", J Am Soc Echocardiogr, 26, pp.1306~1313 (2013)
- Padang R, "Prevalence and impact of coexistent bicuspid aortic valve in hypertrophic cardiomyopathy", Heart Lung Circ, 27, pp.33~40 (2018)
- Lang RM, "Recommendations for cardiac chamber quantification by echocardiography in adults : an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging", Eur Heart J Cardiovasc Imaging, 16, pp.233~270 (2015)
- Lee SY, "Factors determining aortic valve dysfunction in Korean subjects with a bicuspid aortic valve", Am J Cardiol, 119, pp.2049~2055 (2017)
- Roberts WC, "Frequency by decades of unicuspid, bicuspid, and tricuspid aortic valves in adults having isolated aortic valve replacement for aortic stenosis, with or without associated aortic regurgitation", Circulation, 111, pp.920~925 (2005)
- Zoghbi WA, "Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography", J Am Soc Echocardiogr, 16, pp.777~802 (2003)
- Baumgartner H, "Echocardiographic assessment of valve stenosis : EAE", ASE recommendations for clinical practice, 2009, pp.22, 1~23
- Jenni R, "Echocardiographic and pathoanatomical characteristics of isolated left ventricular non-compaction : a step towards classification as a distinct cardiomyopathy", Heart, 86, pp.666~671 (2001)
- Chin TK, "Isolated noncompaction of left ventricular myocardium. A study of eight cases", Circulation, 82, pp.507~513 (1990)
- Stöllberger C, "Left ventricular hypertrabeculation", noncompaction and association with additional cardiac abnormalities and neuromuscular disorders, 2002, pp.90, 899~902
- Petersen SE, "Left ventricular thrombi in a patient with left ventricular non-compaction in visualisation of the rationale for anticoagulation", Heart, 91, pp.e4~ (2005)
- Yancy CW, "2017 ACC", AHA, AHA Guideline for the management of heart failure : a report of the American College of Cardiology, pp.American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America, J Am Coll Cardiol[DOI]
- Chandra S, "Bicuspid aortic valve : Inter-racial difference in frequency and aortic dimensions", JACC Cardiovasc Imaging, 5, pp.981~989 (2012)
- Somerville J, "Congenital anomalies in the heart with hypertrophic cardiomyopathy", Br Heart J, 30, pp.713~722 (1968)