JACC. Cardiovascular imaging
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JACC Cardiovasc Imaging · Dec 2013
Pattern of ascending aortic dimensions predicts the growth rate of the aorta in patients with bicuspid aortic valve.
This study sought to identify risk factors for rapid growth of the ascending aorta in patients with bicuspid aortic valve (BAV) disease, taking into account its phenotypic variability. ⋯ In patients with BAV, the root phenotype (aortic dilation predominantly at the sinuses, with normal or less dilated ascending tract) may be a marker of more severe aortopathy, warranting closer surveillance and earlier treatment. The more common ascending phenotype proved to be a more stable disease entity, generally with slower progression.
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JACC Cardiovasc Imaging · Dec 2013
Review Meta AnalysisSurgical thresholds for bicuspid aortic valve associated aortopathy.
This systematic review seeks to present the outcomes of the natural history of aortopathy associated with bicuspid aortic valve (ABAV) and after interventions. ⋯ The risk associated with ABAV varies according to age and clinical setting. Nonetheless, despite aortic dilatation, the acute aortic event risk of ABAV appears low in current practice. Decision-making regarding the timing of intervention needs to be made on the basis of the balance between this low risk and both the morbidity and mortality of surgery.
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JACC Cardiovasc Imaging · Dec 2013
Multicenter StudyRV contractility and exercise-induced pulmonary hypertension in chronic mountain sickness: a stress echocardiographic and tissue Doppler imaging study.
The aim of this study was to evaluate right ventricular (RV) and left ventricular function and pulmonary circulation in chronic mountain sickness (CMS) patients with rest and stress echocardiography compared with healthy high-altitude (HA) dwellers. ⋯ Comparable RV contractile reserve in CMS and HA suggests that the lower resting values of RV function in CMS may represent a physiological adaptation to chronic hypoxic conditions rather than impaired RV function. (Chronic Mountain Sickness, Systemic Vascular Function [CMS]; NCT01182792).
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JACC Cardiovasc Imaging · Dec 2013
Aortic surgery for ascending aortic aneurysms under 5.0 cm in diameter in the presence of bicuspid aortic valve.
Aneurysm of the ascending aorta may cause acute type A aortic dissection, and the primary aim of a prophylactic operation is avoidance of this life-threatening complication. Current guidelines recommend prophylactic replacement of the aneurysmal ascending aorta at a diameter of ≥5.5 cm. ⋯ Because surgical advances have led to a reduction of early surgical mortality between 1% and 3%, many clinicians believe that surgery is warranted in smaller aortas. Given the frequency of a bicuspid aortic valve (BAV), such a strategy has health implications for this population.