Bicuspid aortic stenosis risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]; Usama Talib, BSc, MD [3]

Overview

Risk factors of bicuspid aortic valve to progress to stenosis are hypercholesterolaemia, hypertension and asymmetrical leaflets.

Risk Factors

Factors affecting the rate of stenosis of bicuspid valves are not clearly defined.

  • The rate of calcification of the bicuspid aortic valve depends on:[1]
    • Total cholesterol
    • Hypertension
    • Asymmetrical leaflet sizes as there is more pronounced hemodynamic stress, resulting from straightening and stretching of the leaflets when they are open and close[2]
  • Sclerotic changes resulting in stenosis tend to occur at faster rate in patients with:[3]
    • Anteroposteriorly located cusps than in those with right-left located cusps
    • Asymmetrical leaflet sizes

There are increasing evidences of heritability of bicuspid aortic valves which follows autosomal dominant inheritance pattern.[4][5]

References

  1. Chan KL, Ghani M, Woodend K, Burwash IG (2001). "Case-controlled study to assess risk factors for aortic stenosis in congenitally bicuspid aortic valve". The American Journal of Cardiology. 88 (6): 690–3. PMID 11564401. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  2. EDWARDS JE (1961). "The congenital bicuspid aortic valve". Circulation. 23: 485–8. PMID 13725804. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  3. Beppu S, Suzuki S, Matsuda H, Ohmori F, Nagata S, Miyatake K (1993). "Rapidity of progression of aortic stenosis in patients with congenital bicuspid aortic valves". The American Journal of Cardiology. 71 (4): 322–7. PMID 8427176. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  4. Huntington K, Hunter AG, Chan KL (1997). "A prospective study to assess the frequency of familial clustering of congenital bicuspid aortic valve". Journal of the American College of Cardiology. 30 (7): 1809–12. PMID 9385911. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  5. Cripe L, Andelfinger G, Martin LJ, Shooner K, Benson DW (2004). "Bicuspid aortic valve is heritable". Journal of the American College of Cardiology. 44 (1): 138–43. doi:10.1016/j.jacc.2004.03.050. PMID 15234422. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)

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