Prevalence of aortic valve prolapse with bicuspid aortic valve and its relation to aortic regurgitation

A cross-sectional echocardiographic study

William J. Stewart, Mary Etta King, Linda Gillam, David E. Guyer, Arthur E. Weyman

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Although aortic valve prolapse (AVP) has been suggested as a cause of aortic regurgitation (AR) in patients with bicuspid aortic valves, neither the frequency of AVP nor its relation to AR in this setting has been defined. To assess these relations, 64 patients with bicuspid aortic valves diagnosed by 2-dimensional echocardiography and 20 normal subjects, similarly distributed according to age and sex, were studied. The presence and degree of AVP were defined using 3 quantitative terms: aortic valve prolapse distance (AVPD), area (AVPA) and volume (AVPV). Each was corrected (c) for patient size with reference to the diameter of the aorta at the level of insertion of the valve cusps. In normal subjects, the AVPDc averaged 0.09 ± 0.06 (range 0 to 0.16) and the AVPAc averaged 0.08 ± 0.06 cm (range 0 to 0.15). In patients with bicuspid aortic valves, the AVPDc averaged 0.26 ± 0.10 (range 0.11 to 0.59, p = 0.00005 vs normal subjects), whereas the AVPAc averaged 0.35 ± 0.17 cm (range 0.05 to 0.90, p = 0.00005 vs normal subjects). When the AVPDc criteria were used, 81% of the bicuspid valves were abnormal; when the AVPAc criteria were used, 87% were abnormal. The degree of prolapse defined by the AVPVc, which considers both cusp area and degree of apical displacement, was significantly greater for patients with bicuspid aortic valve with clinical AR than for those without (p = 0.008). However, because of the overlap between groups, there was no point at which this measure uniquely separated patients with and without AR. There was no relation between the degree of prolapse and either age or degree of cusp asymmetry. The degree of AVP was greater in bicuspid valves with vertical vs those with horizontal commissures. AVP, therefore, occurs often in patients with bicuspid aortic valves; however, neither the presence nor the degree of AVP can be used to predict clinical AR.

Original languageEnglish (US)
Pages (from-to)1277-1282
Number of pages6
JournalThe American Journal of Cardiology
Volume54
Issue number10
DOIs
StatePublished - Dec 1 1984
Externally publishedYes

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Aortic Valve Prolapse
Aortic Valve Insufficiency
Cross-Sectional Studies
Prolapse
Mitral Valve
Bicuspid Aortic Valve
Echocardiography
Aorta

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Prevalence of aortic valve prolapse with bicuspid aortic valve and its relation to aortic regurgitation: A cross-sectional echocardiographic study",
abstract = "Although aortic valve prolapse (AVP) has been suggested as a cause of aortic regurgitation (AR) in patients with bicuspid aortic valves, neither the frequency of AVP nor its relation to AR in this setting has been defined. To assess these relations, 64 patients with bicuspid aortic valves diagnosed by 2-dimensional echocardiography and 20 normal subjects, similarly distributed according to age and sex, were studied. The presence and degree of AVP were defined using 3 quantitative terms: aortic valve prolapse distance (AVPD), area (AVPA) and volume (AVPV). Each was corrected (c) for patient size with reference to the diameter of the aorta at the level of insertion of the valve cusps. In normal subjects, the AVPDc averaged 0.09 ± 0.06 (range 0 to 0.16) and the AVPAc averaged 0.08 ± 0.06 cm (range 0 to 0.15). In patients with bicuspid aortic valves, the AVPDc averaged 0.26 ± 0.10 (range 0.11 to 0.59, p = 0.00005 vs normal subjects), whereas the AVPAc averaged 0.35 ± 0.17 cm (range 0.05 to 0.90, p = 0.00005 vs normal subjects). When the AVPDc criteria were used, 81{\%} of the bicuspid valves were abnormal; when the AVPAc criteria were used, 87{\%} were abnormal. The degree of prolapse defined by the AVPVc, which considers both cusp area and degree of apical displacement, was significantly greater for patients with bicuspid aortic valve with clinical AR than for those without (p = 0.008). However, because of the overlap between groups, there was no point at which this measure uniquely separated patients with and without AR. There was no relation between the degree of prolapse and either age or degree of cusp asymmetry. The degree of AVP was greater in bicuspid valves with vertical vs those with horizontal commissures. AVP, therefore, occurs often in patients with bicuspid aortic valves; however, neither the presence nor the degree of AVP can be used to predict clinical AR.",
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Prevalence of aortic valve prolapse with bicuspid aortic valve and its relation to aortic regurgitation : A cross-sectional echocardiographic study. / Stewart, William J.; King, Mary Etta; Gillam, Linda; Guyer, David E.; Weyman, Arthur E.

In: The American Journal of Cardiology, Vol. 54, No. 10, 01.12.1984, p. 1277-1282.

Research output: Contribution to journalArticle

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