Characteristic Analysis Of Valve Dysfunction In Bicuspid Aortic Valve:Implications For Transcatheter Aortic Valve Implantation

Objective:Bicuspid aortic valve(BAV)is the most common congenital heart valve disease.The present study aimed to analyze the prevalence and valve dysfunction of BAV to provide information for the application of transcatheter aortic valve implantation(TAVI).Methods : The echocardiography database of the First Affiliated Hospital of Xinjiang Medical University from January 2011 to December 2016 was included.Patients were divided into four different age groups: group A: ≤50 years old;Group B:51-60 years old;Group C :61-70 years old;Group D: ≥71 years old.Due to the small sample size of other ethnic groups,this paper focuses on the Han,Uygur and Kazak nationalities.The prevalence,valvular dysfunction,and cardiac structure and function of BAV patients were analyzed according to different ages,genders and nationalities,and the prevalence of aortic valve stenosis(AS)and aortic valve regurgitation(AR)in BAV patients was further analyzed to provide information for the application of TAVI.Results:A total of 130,358 patients were included in the database of echocardiography.Of them,770(0.59%)were BAV patients,including 196(25.45%)females and 574(74.55%)males,with an average age of 48.73 ± 14.35 years.The ethnic groups included Han nationality 330 cases(42.86%),Uighur 343 cases(44.55%),kazak 55 cases(7.14%),and other minorities 42 cases(5.45%).743 patients(96.49%)had different degrees of valve dysfunction: 245 patients(31.8%)had AS,630 patients(81.8%)had AR,and 206patients(26.75%)had AS with AR.The prevalence of AS,AS with AR,aortic valve calcification(AVC)increased with age.Women tend to have AS,while men easily suffer from AR.The concomitant AVC in men was also significantly higher than that of women(32.8% vs 21.9%,P<0.05).The prevalence of BAV patients of uygur nationality was significantly higher than that of han nationality,and the difference of age between BAV patients of each ethnic group was statistically significant.Patients of han nationality with AS were significantly higher than those of uygur nationality,on the contrary,patients of uygur nationality with AR were significantly higher than those of han nationality,with statistically significant differences(P < 0.05).The inner diameter and ring diameter of the aortic sinus in uygur were significantly higher than those in han nationality,the difference was statistically significant.Conclusions: The prevalence of BAV with AS,AS with AR and AVC increased gradually with age.Female BAV patients are more likely to accompany with AS,while male is more likely to accompany with AR.In the patients with BAV accompany with AS,the Han nationality was the highest,while in the patients with BAV accompany with AR,the Uygur nationality was the highest.Early echocardiographic screening should be performed.