Abnormal aortic stiffness in patients with bicuspid aortic valve: phenotypic variation determined by magnetic resonance imaging

  • Thananya BoonyasirinantEmail author
  • Prabhakar Rajiah
  • Scott D. Flamm
Original Paper


The aim of this study was to assess aortic stiffness in patients with bicuspid aortic valve (BAV), and to determine if differences exist among the BAV phenotypes. Stiffness was measured by pulse wave velocity (PWV) determined using velocity-encoded magnetic resonance imaging (VENC-MRI). VENC-MRI was performed in 100 BAV patients and 45 normal controls. PWV was determined between the mid ascending and mid descending aorta. The BAV phenotypes were characterized using steady-state free precession (SSFP) images acquired across the face of the aortic valve, and classified as follows: right-left cusp (R-L) fusion, right and non-coronary cusp (R-NC) fusion, and left and non-coronary cusp (L-NC) fusion. The following BAV phenotypes were identified: 76 R-L, 23 R-NC, and 1 L-NC fusion. BAV patients demonstrated significantly greater PWV compared to normal controls, after adjusting for age (9.16 vs. 3.83 m/s; p < 0.0001). Furthermore, PWV was significantly greater in patients with R-NC fusion than those with R-L fusion phenotype (12.27 vs. 7.97 m/s; p < 0.001). There was significantly increased PWV from VENC-MRI in BAV patients compared to normal controls. Thisis the first to demonstrate the association of different BAV phenotypes and aortic stiffness. VENC-MRI PWV assessment potentially represents a novel parameter for enhanced surveillance and may alter surgical triage of aorta in this high risk group.


Bicuspid aortic valve Valve phenotype Aortic stiffness Pulse wave velocity 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  • Thananya Boonyasirinant
    • 1
    • 2
    Email author
  • Prabhakar Rajiah
    • 1
  • Scott D. Flamm
    • 1
    • 3
  1. 1.Cardiovascular Imaging LaboratoryImaging InstituteClevelandUSA
  2. 2.Division of Cardiology, Department of Internal Medicine, Siriraj HospitalMahidol UniversityBangkokThailand
  3. 3.Cardiovascular MedicineHeart and Vascular Institute, Cleveland ClinicClevelandUSA

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