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Abstract：
Background/Objectives: The aim of this study was to analyze a group of patients with a bicuspid aortic valve (BAV) examined with ECG-gated cardiac CT (ECG-CT), focusing on the assessment of the clinical reasons for cardiac CT, cardiovascular abnormalities coexisting with their BAV, and coronary artery stenosis. Methods: A detailed statistical analysis was conducted on 700 patients with a BAV from a group of 15,670 patients examined with ECG-CT. Results: The incidence of a BAV in ECG-CT was 4.6%. The most common reason for examination was suspicion of coronary heart disease-31.1%. Cardiovascular defects most frequently associated with a BAV were a VSD (4.3%) and coarctation of the aorta (3.6%), while among coronary anomalies, they were high-take-off coronary arteries (6.4%) and paracommissural orifice of coronary arteries (4.4%). The analysis of the coronary artery calcium index showed significantly lower values for type 2 BAV compared to other valve types (p < 0.001), with the lowest average age in this group of patients. Moreover, the presence of a raphe between the coronary and non-coronary cusps was associated with a higher rate of significant coronary stenosis compared to other types of BAVs (p < 0.001). Conclusions: The most common reason for referral for cardiac ECG-CT in the group ≤ 40-year-olds with a BAV was the suspicion of congenital cardiovascular defects, while in the group of over 40-year-olds, it was the suspicion of coronary artery disease. The incidence of cardiovascular abnormalities co-occurring with BAV and diagnosed with ECG-CT differs among specific patient subgroups. The presence of a raphe between the coronary and non-coronary cusps appears to be a potential risk factor for significant coronary stenosis in patients with BAVs.
摘要：
背景/目的：本研究的目的是分析一组使用ECG门控心脏CT（ECG-CT）检查的二叶主动脉瓣（BAV）患者，重点评估心脏CT的临床原因，心血管异常与他们的BAV共存，冠状动脉狭窄.方法：对15,670例经ECG-CT检查的BAV患者中的700例进行了详细的统计分析。结果：ECG-CT中BAV的发生率为4.6％。最常见的检查原因是怀疑冠心病-31.1％。与BAV最常见的心血管缺陷是VSD（4.3％）和主动脉缩窄（3.6％），而在冠状动脉异常中，它们是高起飞的冠状动脉(6.4%)和冠状动脉旁路口(4.4%)。对冠状动脉钙指数的分析显示，与其他瓣膜类型相比，2型BAV的值明显较低（p<0.001），该组患者的平均年龄最低。此外，与其他类型的BAVs相比,冠状动脉和非冠状动脉尖点之间存在的间隙与更高的显著冠状动脉狭窄率相关(p<0.001).结论：在≤40岁的BAV患者中，进行心脏ECG-CT转诊的最常见原因是怀疑先天性心血管缺陷，而在40岁以上的人群中，怀疑是冠状动脉疾病。与BAV并发并经ECG-CT诊断的心血管异常的发生率在特定患者亚组之间不同。在BAVs患者中，冠状动脉和非冠状动脉尖之间存在缝似乎是严重冠状动脉狭窄的潜在危险因素。
