Aortic & peripheral vascular disease
Flow dynamics and systemic arterial stiffness distinguish bicuspid aortic valve aortopathy from heritable thoracic aortic disease
Authors' conclusion
BAVA and HTAD show distinct morphological and haemodynamic phenotypes: BAVA with focal dilation, elevated WSSCMR/ELCMR and preserved systemic function; HTAD with reduced local distensibility and greater systemic stiffness. These aetiology-specific predictors are exploratory and require external validation.
Study context
- Population
- Patients with bicuspid aortic valve-associated aortopathy (BAVA) or heritable thoracic aortic disease (HTAD)
- Participants
- 185 patients
- Comparison
- Morphological and haemodynamic profiles between both groups
- BAVAn = 111
- HTADn = 74
- Outcome
- Tubular ascending aorta and sinotubular junction dilation
Main finding
As reported in the abstract
- BAVA showed greater tubular ascending aorta and sinotubular junction dilation
Further findings
Association with events, aetiology-specific analyses
| HR (95% CI) | ||
|---|---|---|
| Ascending aorta WSSCMRIn BAVA · exploratory aetiology-specific analyses | 8.92 (2.85–27.95) | |
| Systemic PWVMIn HTAD · exploratory aetiology-specific analyses | 2.16 (1.30–3.57) | |
| 0.050.21520Hazard ratio (log scale) |
| Outcome | BAVA | HTAD | P value |
|---|---|---|---|
| Ascending aorta WSSCMR | 0.42±0.18 Pa | 0.28±0.12 Pa | P = 0.020 |
| ELCMR | 19.8±8.4 mW | 12.3±6.1 mW | P < 0.001 |
| ADCMR | 6.1 ± 3.5 ×10-3 mmHg-1 | 4.8 ± 2.9 ×10-3 mmHg-1 | P = 0.023 |
| PWVMLower systemic stiffness in BAVA than HTAD | 6.2±1.7 m/s | 7.8±2.1 m/s | P < 0.001 |
| AIxMLower systemic stiffness in BAVA than HTAD | 12.1±7.6 % | 18.4±9.2 % | P < 0.001 |
Composite adverse aortic events (AAE): acute aortic syndrome, cardiovascular death or guideline diameter-based indication for surgery · over 42.1±17.6 months
- AAE rates were similar
Original publication
Flow dynamics and systemic arterial stiffness distinguish bicuspid aortic valve aortopathy from heritable thoracic aortic disease. Eur Heart J Cardiovasc Imaging. Published 2 November 2026. doi:10.
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