PDF(Pubmed)
Abstract：
Bicuspid aortic valve (BAV) patients have an increased risk to develop thoracic aortic complications. Little is known about the prevalence and severity of atherosclerosis in the BAV ascending aortic wall. This study evaluates and compares the prevalence of thoracic aortic atherosclerosis in BAV and tricuspid aortic valve (TAV) patients.
Atherosclerosis was objectified using three diagnostic modalities in two separate BAV patient cohorts (with and without an aortic dilatation). Within the first group, atherosclerosis was graded histopathologically according to the modified AHA classification scheme proposed by Virmani et al. In the second group, the calcific load of the ascending aorta and coronary arteries, coronary angiographies and cardiovascular risk factors were studied. Patients were selected from a surgical database (treated between 2006-2020), resulting in a total of 128 inclusions.
Histopathology showed atherosclerotic lesions to be more prevalent and severe in all TAV as compared to all BAV patients (OR 1.49 (95%CI 1.14 - 1.94); p = 0.003). Computed tomography showed no significant differences in ascending aortic wall calcification between all BAV and all TAV patients, although a tendency of lower calcific load in favor of BAV was seen. Coronary calcification was higher in all TAV as compared to all BAV (OR 1.30 (95%CI 1.06 - 1.61); p = 0.014).
Ascending aortic atherosclerotic plaques were histologically more pronounced in TAV as compared to the BAV patients, while CT scans revealed equal amounts of calcific depositions within the ascending aortic wall. This study confirms less atherosclerosis in the ascending aortic wall and coronary arteries of BAV patients as compared to TAV patients. These results were not affected by the presence of a thoracic aortic aneurysm.
Atherosclerosis was objectified using three diagnostic modalities in two separate BAV patient cohorts (with and without an aortic dilatation). Within the first group, atherosclerosis was graded histopathologically according to the modified AHA classification scheme proposed by Virmani et al. In the second group, the calcific load of the ascending aorta and coronary arteries, coronary angiographies and cardiovascular risk factors were studied. Patients were selected from a surgical database (treated between 2006-2020), resulting in a total of 128 inclusions.
Histopathology showed atherosclerotic lesions to be more prevalent and severe in all TAV as compared to all BAV patients (OR 1.49 (95%CI 1.14 - 1.94); p = 0.003). Computed tomography showed no significant differences in ascending aortic wall calcification between all BAV and all TAV patients, although a tendency of lower calcific load in favor of BAV was seen. Coronary calcification was higher in all TAV as compared to all BAV (OR 1.30 (95%CI 1.06 - 1.61); p = 0.014).
Ascending aortic atherosclerotic plaques were histologically more pronounced in TAV as compared to the BAV patients, while CT scans revealed equal amounts of calcific depositions within the ascending aortic wall. This study confirms less atherosclerosis in the ascending aortic wall and coronary arteries of BAV patients as compared to TAV patients. These results were not affected by the presence of a thoracic aortic aneurysm.
摘要：
背景：二叶主动脉瓣（BAV）患者发生胸主动脉并发症的风险增加。关于BAV升主动脉壁中动脉粥样硬化的患病率和严重程度知之甚少。这项研究评估和比较了BAV和三尖瓣主动脉瓣（TAV）患者的胸主动脉粥样硬化的患病率。
方法：在两个独立的BAV患者队列（有和没有主动脉扩张）中，使用三种诊断方式对动脉粥样硬化进行了客观化。在第一组中，根据Virmani等人提出的改良AHA分类方案对动脉粥样硬化进行组织病理学分级.在第二组中,升主动脉和冠状动脉的钙化负荷，研究了冠状动脉造影和心血管危险因素。患者从手术数据库中选择（2006-2020年间治疗），共产生128个夹杂物。
结果：组织病理学显示，与所有BAV患者相比，所有TAV患者的动脉粥样硬化病变更为普遍和严重（OR1.49（95CI1.14-1.94）；p=0.003）。计算机断层扫描显示所有BAV和所有TAV患者升主动脉壁钙化没有显着差异。尽管看到了较低的钙化负荷有利于BAV的趋势。与所有BAV相比，所有TAV的冠状动脉钙化均较高（OR1.30（95CI1.06-1.61）；p=0.014）。
结论：与BAV患者相比，TAV中的升主动脉粥样硬化斑块在组织学上更为明显。而CT扫描显示升主动脉壁内有等量的钙化沉积。这项研究证实，与TAV患者相比，BAV患者的升主动脉壁和冠状动脉的动脉粥样硬化较少。这些结果不受胸主动脉瘤的影响。
方法：在两个独立的BAV患者队列（有和没有主动脉扩张）中，使用三种诊断方式对动脉粥样硬化进行了客观化。在第一组中，根据Virmani等人提出的改良AHA分类方案对动脉粥样硬化进行组织病理学分级.在第二组中,升主动脉和冠状动脉的钙化负荷，研究了冠状动脉造影和心血管危险因素。患者从手术数据库中选择（2006-2020年间治疗），共产生128个夹杂物。
结果：组织病理学显示，与所有BAV患者相比，所有TAV患者的动脉粥样硬化病变更为普遍和严重（OR1.49（95CI1.14-1.94）；p=0.003）。计算机断层扫描显示所有BAV和所有TAV患者升主动脉壁钙化没有显着差异。尽管看到了较低的钙化负荷有利于BAV的趋势。与所有BAV相比，所有TAV的冠状动脉钙化均较高（OR1.30（95CI1.06-1.61）；p=0.014）。
结论：与BAV患者相比，TAV中的升主动脉粥样硬化斑块在组织学上更为明显。而CT扫描显示升主动脉壁内有等量的钙化沉积。这项研究证实，与TAV患者相比，BAV患者的升主动脉壁和冠状动脉的动脉粥样硬化较少。这些结果不受胸主动脉瘤的影响。
