Clinical and echocardiographic determinants in bicuspid aortic dilatation Results from a longitudinal observational study

Frederique E. C. M. Peeters, Noreen Van der Linden, Alissa L. L. Thomassen, Harry J. G. M. Crijns, Steven J. R. Meex, Bas L. J. H. Kietselaer*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Bicuspid aortic valve (BAV) disease is associated with aortic dilatation. Timing of follow-up and surgery is challenging. Hence, there is an unmet clinical need for additional risk stratification. It is unclear whether valve morphology is associated with dilatation rates. Therefore, the objective of this study was to examine the association between clinical and echocardiographic determinants (including valve morphology) and aortic dimension and the progression rate of dilatation. Aortic dimensions were assessed on serial echocardiographic images between 1999 and 2014 in a population of 392 patients with BAVs in a tertiary care center in the Netherlands. Analyses using mixed linear models were performed. Mean age of participants was 48 +/- 17 years and 69% were male. BAV morphology was associated with aortic dimensions, as well as age, sex, BSA, and valvular dysfunction. Tubular ascending aorta, sinus of Valsalva, and sinotubular junction showed a dilatation rate of 0.32, 0.18, and 0.06mm/year, respectively. Dilatation rate was not associated with valve morphology. In the present study, there is no association between BAV morphology and aortic dilatation rates. Therefore, morphology is of limited use in prediction of aortic growth. Discovering fast progressors remains challenging.
Original languageEnglish
Article numbere5699
Number of pages6
Issue number52
Publication statusPublished - Dec 2016


  • aortic dilatation
  • aortic dilatation rate
  • aortic dimensions
  • bicuspid aortic valve
  • thoracic aorta

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