Highlights • With 4D flow, any plane of interest can be interactively chosen for quantitative measurements. • Anatomical and flow data is obtained during an approximately 10-minute free-breathing ...scan. • 4D CMR flow measurements correlated well with the 2D PC ones. • Eddy current correction is important for good results with 4D flow
Bicuspid aortic valve (BAV) is a common congenital heart defect. Patients with BAV are at risk for long-term complications such as valve stenosis and regurgitation. This study aimed to investigate ...(1) sex differences in blood and imaging biomarkers and (2) describe the long-term prognostic value of blood and echocardiographic biomarkers.
Patients were included from two prospective observational cohort studies, patients underwent venous blood sampling and transthoracic echocardiography including speckle tracking. Analyzed blood biomarkers were: RDW, creatinine, CRP, TroponinT, NT-proBNP and TGF-β. Sex differences were analyzed at baseline. Associations between biomarkers and arrhythmia-free and intervention-free survival were determined by Cox regression, adjusted for age and sex.
182 BAV patients were included (median age 34 (IQR: 23-46) years, 55.5% male). CRP, NT-proBNP and RDW were higher in women while creatinine, TroponinT and TGF-β were higher among men. After a median follow-up time of 6.9 (IQR: 6.5-9.9) years, arrhythmia-free and intervention-free survival were respectively 81.0% and 73.1%. NT-proBNP was associated with both arrhythmia-free and intervention-free survival (HR 1.94, p=0.005 and HR 2.06, p=0.002 respectively). On echocardiography higher LA size, LVEDD, LV mass index and E/e’ ratio were associated with lower arrhythmia-free survival, while higher LA size, LV mass index, aortic valve peak velocity and aortic regurgitation were associated with lower intervention-free survival.
Differences were observed in blood biomarkers between men and women with BAV. Besides LV systolic parameters, diastolic LV function and NT-proBNP should have a more prominent role as prognostic markers in clinical care.
