{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:34:53Z","timestamp":1761863693877},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,4,8]],"date-time":"2017-04-08T00:00:00Z","timestamp":1491609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL115828","K25HL119608"],"award-info":[{"award-number":["R01HL115828","K25HL119608"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["16POST27520030"],"award-info":[{"award-number":["16POST27520030"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Valve mediated hemodynamics have been postulated to contribute to pathology of the ascending aorta (AAo). The objective of this study is to assess the association of aortic valve morphology and hemodynamics with downstream AAo size in subjects with bicuspid aortic valve (BAV) disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Four\u2010dimensional flow MRI at 1.5 or 3 Tesla was used to evaluate the hemodynamics in the proximal AAo of 52 subjects: size\u2010matched controls with tricuspid aortic valves (n = 24, mid ascending aorta [MAA] diameter = 38.0 \u00b1 4.9 mm) and BAV patients with aortic dilatation (n = 14 right and left coronary leaflet fusion [RL]\u2010BAV, MAA diameter = 38.1 \u00b1 5.3 mm; n = 14 right and noncoronary leaflet fusion [RN]\u2010BAV, MAA diameter = 36.5 \u00b1 6.6 mm). A validated semi\u2010automated technique was used to evaluate hemodynamic metrics (flow angle, flow displacement, and jet quadrant) and valve morphology (orifice circularity) for all subjects. Regression analysis of these metrics to AAo diameter was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>RN\u2010BAV subjects displayed a stronger correlation between hemodynamic metrics in the proximal AAo with diameter in the distal AAo compared with size\u2010matched tricuspid aortic valve (TAV) controls and RL\u2010BAV subjects. The distal AAo diameter was found to be strongly correlated to the upstream flow displacement (R<jats:sup>2<\/jats:sup><jats:sub>adjusted<\/jats:sub> = 0.75) and flow angle (R<jats:sup>2<\/jats:sup><jats:sub>adjusted<\/jats:sub> = 0.66) measured at the sino\u2010tubular junction (STJ). Orifice circularity was also strongly correlated (R<jats:sup>2<\/jats:sup><jats:sub>adjusted<\/jats:sub> = 0.53) to the distal AAo diameter in RN\u2010BAV subjects. For TAV controls and RL\u2010BAV subjects, correlations were weaker (R<jats:sup>2<\/jats:sup><jats:sub>adjusted<\/jats:sub> &lt; 0.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hemodynamics in the STJ were strongly correlated to the distal AAo diameter for the RN\u2010BAV subjects. Hemodynamic metrics were more strongly correlated to the downstream aortic size when compared with valve morphology metrics.<\/jats:p><jats:p><jats:bold>Level of Evidence:<\/jats:bold> 3<\/jats:p><jats:p><jats:bold>Technical Efficacy:<\/jats:bold> Stage 2<\/jats:p><jats:p>J. Magn. Reson. Imaging 2018;47:246\u2013254.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.25719","type":"journal-article","created":{"date-parts":[[2017,4,8]],"date-time":"2017-04-08T15:22:39Z","timestamp":1491664959000},"page":"246-254","source":"Crossref","is-referenced-by-count":29,"title":["Valve mediated hemodynamics and their association with distal ascending aortic diameter in bicuspid aortic valve subjects"],"prefix":"10.1002","volume":"47","author":[{"given":"Vrishank","family":"Raghav","sequence":"first","affiliation":[{"name":"Georgia Institute of Technology Atlanta Georgia USA"},{"name":"Auburn University Auburn Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex J.","family":"Barker","sequence":"additional","affiliation":[{"name":"Northwestern University Evanston Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Mangiameli","sequence":"additional","affiliation":[{"name":"Georgia Institute of Technology Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Mirabella","sequence":"additional","affiliation":[{"name":"Georgia Institute of Technology Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Markl","sequence":"additional","affiliation":[{"name":"Northwestern University Evanston Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajit P.","family":"Yoganathan","sequence":"additional","affiliation":[{"name":"Georgia Institute of Technology Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,4,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000027905.26586.E8"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.01.039"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2007.132092"},{"key":"e_1_2_6_5_1","doi-asserted-by":"crossref","DOI":"10.1155\/2012\/196037","article-title":"Bicuspid aortic valve disease: a comprehensive review","volume":"2012","author":"Mordi I","year":"2012","journal-title":"Cardiol Res Pract"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/heart.83.1.81"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2011.01.001"},{"key":"e_1_2_6_8_1","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.tcm.2014.12.016","article-title":"The bicuspid aortic valve aortopathy mystery continues: are we that mediocre?","volume":"25","author":"Michelena HI","year":"2015","journal-title":"Trends Cardiovasc Med"},{"key":"e_1_2_6_9_1","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/j.ejcts.2011.02.007","article-title":"Aortopathy in bicuspid aortic valve disease\u2014genes or hemodynamics? 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