2024/10 - Regional Aortic Wall Shear Stress Increases over Time in Patients with a Bicuspid Aortic Valve [Journal Club]-2024/10 - Regional Aortic Wall Shear Stress Increases over Time in Patients with a Bicuspid Aortic Valve [Journal Club]

2024/10 - Regional Aortic Wall Shear Stress Increases over Time in Patients with a Bicuspid Aortic Valve [Journal Club]

Video Transcription

Video Summary

The webinar introduced a recent JCMR paper on bicuspid aortic valve (BAV) patients, focusing on regional aortic wall shear stress (WSS) measured with 4D flow CMR. The study explained how BAV causes abnormal blood flow jets that increase WSS in specific areas of the ascending aorta, especially the outer proximal region. Researchers compared healthy controls with high-risk BAV patients and followed some patients for about three years.<br /><br />Using detailed regional mapping of the aorta, they found that WSS magnitude, axial WSS, and circumferential WSS all increased over time in BAV patients, while WSS angle decreased. These changes occurred even in patients without significant aortic stenosis and were seen regardless of whether the aorta had enlarged. Patients with more severe valve fusion patterns showed less favorable WSS profiles.<br /><br />The discussion emphasized the possible role of both hemodynamic and genetic mechanisms in BAV aortopathy. Peak aortic valve velocity, normalized flow displacement, aortic distensibility, and aortic valve rotation were identified as important factors linked to WSS changes. The speakers highlighted the value of regional analysis and the potential clinical use of these findings to guide follow-up frequency and risk stratification in BAV patients.

Keywords

bicuspid aortic valve

regional aortic wall shear stress

4D flow CMR

ascending aorta

hemodynamic jets

aortopathy

aortic valve fusion patterns

flow displacement

risk stratification