Prevalence of Aortic Dilation in Patients with Bicuspid Aortic Valve According to Reference Values for the Argentine Population. Influence of the Indexing Method

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Abstract

Background: A significant proportion of patients with bicuspid aortic valve (BAV) develop aortic dilation predisposing to serious complications.

Objective: The aim of this study was to estimate the prevalence of aortic dilation applying reference values for the Argentine population in patients with BAV, and the influence of different indexing methods [height, (H) and body surface area (BSA)]

Methods: A total of 581 adult patients with BAV were consecutively included in the study. Aortic dilation was defined according to guideline criteria (Devereux formula) and the reference values suggested by the Echocardiography Thoracic Aortic Assessment in Argentina (MATEAR) registry.

Results: Mean age was 44.9±16 years and 68.7% were men. A high prevalence of aortic root or ascending aorta dilation was observed based on MATEAR criteria (72.3% according to H and 61.5 % according to BSA). This was significantly higher for theç aortic root than the one obtained with the Devereux formula (H: 47% vs. 31.5%; BSA: 35.2% vs. 26.5% P <0.001). A systematic underestimation was found when indexing for BSA in patients with body mass index (BMI) >25 kg/m² (57.8% of population).

Conclusions: When applying the reference values for the Argentine population the prevalence of aortic dilation was highç and significantly greater than at the root that determined by cutoff points originating in other populations. Systematic underestimation was observed when correcting for BSA in patients with BMI >25 kg/m², so indexing by H would be the most recommended option.