{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:37:48Z","timestamp":1790145468657,"version":"4.0.1"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2018,11,28]],"date-time":"2018-11-28T00:00:00Z","timestamp":1543363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["NIHR-PDF 2011-04-51 Gerald P McCann"],"award-info":[{"award-number":["NIHR-PDF 2011-04-51 Gerald P McCann"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"published-print":{"date-parts":[[2019,5]]},"DOI":"10.1007\/s00330-018-5775-6","type":"journal-article","created":{"date-parts":[[2018,11,28]],"date-time":"2018-11-28T09:21:05Z","timestamp":1543396865000},"page":"2340-2349","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Aortic stiffness in aortic stenosis assessed by cardiovascular MRI: a comparison between bicuspid and tricuspid valves"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1112-3973","authenticated-orcid":false,"given":"Anvesha","family":"Singh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Horsfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soliana","family":"Bekele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Greenwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana K.","family":"Dawson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Berry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Hogrefe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damian J.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G.","family":"Houston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasad","family":"Guntur Ramkumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akhlaque","family":"Uddin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerry P.","family":"McCann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,11,28]]},"reference":[{"key":"5775_CR1","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1136\/heart.83.1.81","volume":"83","author":"C Ward","year":"2000","unstructured":"Ward C (2000) Clinical significance of the bicuspid aortic valve. Heart 83:81\u201385","journal-title":"Heart"},{"key":"5775_CR2","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/S0002-9149(03)00462-4","volume":"92","author":"M Ferencik","year":"2003","unstructured":"Ferencik M, Pape LA (2003) Changes in size of ascending aorta and aortic valve function with time in patients with congenitally bicuspid aortic valves. Am J Cardiol 92:43\u201346","journal-title":"Am J Cardiol"},{"key":"5775_CR3","doi-asserted-by":"publisher","first-page":"2776","DOI":"10.1161\/CIRCULATIONAHA.107.740878","volume":"117","author":"HI Michelena","year":"2008","unstructured":"Michelena HI, Desjardins VA, Avierinos JF et al (2008) Natural history of asymptomatic patients with normally functioning or minimally dysfunctional bicuspid aortic valve in the community. Circulation 117:2776\u20132784","journal-title":"Circulation"},{"key":"5775_CR4","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.amjcard.2008.02.106","volume":"102","author":"WG Guntheroth","year":"2008","unstructured":"Guntheroth WG (2008) A critical review of the American College of Cardiology\/American Heart Association practice guidelines on bicuspid aortic valve with dilated ascending aorta. Am J Cardiol 102:107\u2013110","journal-title":"Am J Cardiol"},{"key":"5775_CR5","doi-asserted-by":"publisher","first-page":"2138","DOI":"10.1161\/01.CIR.99.16.2138","volume":"99","author":"D Bonderman","year":"1999","unstructured":"Bonderman D, Gharehbaghi-Schnell E, Wollenek G, Maurer G, Baumgartner H, Lang IM (1999) Mechanisms underlying aortic dilatation in congenital aortic valve malformation. Circulation 99:2138\u20132143","journal-title":"Circulation"},{"key":"5775_CR6","doi-asserted-by":"publisher","first-page":"11","DOI":"10.2459\/01.JCM.0000199777.85343.ec","volume":"7","author":"M Cecconi","year":"2006","unstructured":"Cecconi M, Nistri S, Quarti A et al (2006) Aortic dilatation in patients with bicuspid aortic valve. J Cardiovasc Med (Hagerstown) 7:11\u201320","journal-title":"J Cardiovasc Med (Hagerstown)"},{"key":"5775_CR7","first-page":"835","volume":"147","author":"F Robicsek","year":"1958","unstructured":"Robicsek F, Sanger PW, Taylor FH, Magistro R, Foti E (1958) Pathogenesis and significance of post-stenotic dilatation in great vessels. Ann Surg 147:835\u2013844","journal-title":"Ann Surg"},{"key":"5775_CR8","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/S0003-4975(03)01249-9","volume":"77","author":"F Robicsek","year":"2004","unstructured":"Robicsek F, Thubrikar MJ, Cook JW, Fowler B (2004) The congenitally bicuspid aortic valve: how does it function? Why does it fail? Ann Thorac Surg 77:177\u2013185","journal-title":"Ann Thorac Surg"},{"key":"5775_CR9","doi-asserted-by":"publisher","first-page":"2588","DOI":"10.1093\/eurheartj\/ehl254","volume":"27","author":"S Laurent","year":"2006","unstructured":"Laurent S, Cockcroft J, Van Bortel L et al (2006) Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 27:2588\u20132605","journal-title":"Eur Heart J"},{"key":"5775_CR10","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1002\/jmri.21886","volume":"30","author":"HB Grotenhuis","year":"2009","unstructured":"Grotenhuis HB, Westenberg JJ, Steendijk P et al (2009) Validation and reproducibility of aortic pulse wave velocity as assessed with velocity-encoded MRI. J Magn Reson Imaging 30:521\u2013526","journal-title":"J Magn Reson Imaging"},{"key":"5775_CR11","first-page":"369","volume":"11","author":"S Nistri","year":"2002","unstructured":"Nistri S, Sorbo MD, Basso C, Thiene G (2002) Bicuspid aortic valve: abnormal aortic elastic properties. J Heart Valve Dis 11:369\u2013373","journal-title":"J Heart Valve Dis"},{"key":"5775_CR12","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1016\/j.ijcard.2007.06.065","volume":"128","author":"SC Yap","year":"2008","unstructured":"Yap SC, Nemes A, Meijboom FJ et al (2008) Abnormal aortic elastic properties in adults with congenital valvular aortic stenosis. Int J Cardiol 128:336\u2013341","journal-title":"Int J Cardiol"},{"key":"5775_CR13","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1093\/eurheartj\/ehm528","volume":"29","author":"S Nistri","year":"2008","unstructured":"Nistri S, Grande-Allen J, Noale M et al (2008) Aortic elasticity and size in bicuspid aortic valve syndrome. Eur Heart J 29:472\u2013479","journal-title":"Eur Heart J"},{"key":"5775_CR14","doi-asserted-by":"publisher","first-page":"1660","DOI":"10.1016\/j.jacc.2006.12.044","volume":"49","author":"HB Grotenhuis","year":"2007","unstructured":"Grotenhuis HB, Ottenkamp J, Westenberg JJ, Bax JJ, Kroft LJ, de Roos A (2007) Reduced aortic elasticity and dilatation are associated with aortic regurgitation and left ventricular hypertrophy in nonstenotic bicuspid aortic valve patients. J Am Coll Cardiol 49:1660\u20131665","journal-title":"J Am Coll Cardiol"},{"key":"5775_CR15","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1093\/eurheartj\/ehx001","volume":"38","author":"A Singh","year":"2017","unstructured":"Singh A, Greenwood JP, Berry C et al (2017) Comparison of exercise testing and CMR measured myocardial perfusion reserve for predicting outcome in asymptomatic aortic stenosis: the PRognostic Importance of MIcrovascular Dysfunction in Aortic Stenosis (PRIMID AS) Study. Eur Heart J 38:1222\u20131229","journal-title":"Eur Heart J"},{"key":"5775_CR16","doi-asserted-by":"publisher","first-page":"e004348","DOI":"10.1136\/bmjopen-2013-004348","volume":"3","author":"A Singh","year":"2013","unstructured":"Singh A, Ford I, Greenwood JP et al (2013) Rationale and design of the PRognostic Importance of MIcrovascular Dysfunction in asymptomatic patients with Aortic Stenosis (PRIMID-AS): a multicentre observational study with blinded investigations. BMJ Open 3:e004348","journal-title":"BMJ Open"},{"key":"5775_CR17","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/1532-429X-14-77","volume":"14","author":"I Voges","year":"2012","unstructured":"Voges I, Jerosch-Herold M, Hedderich J et al (2012) Normal values of aortic dimensions, distensibility, and pulse wave velocity in children and young adults: a cross-sectional study. J Cardiovasc Magn Reson 14:77","journal-title":"J Cardiovasc Magn Reson"},{"key":"5775_CR18","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1093\/ehjci\/jev007","volume":"16","author":"A Singh","year":"2015","unstructured":"Singh A, Horsfield MA, Bekele S, Khan JN, Greiser A, McCann GP (2015) Myocardial T1 and extracellular volume fraction measurement in asymptomatic patients with aortic stenosis: reproducibility and comparison with age-matched controls. Eur Heart J Cardiovasc Imaging 16:763\u2013770","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"5775_CR19","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1148\/radiol.2353040601","volume":"236","author":"T Papavassiliu","year":"2005","unstructured":"Papavassiliu T, K\u00fchl HP, Schr\u00f6der M et al (2005) Effect of endocardial trabeculae on left ventricular measurements and measurement reproducibility at cardiovascular MR imaging. Radiology 236:57\u201364","journal-title":"Radiology"},{"key":"5775_CR20","doi-asserted-by":"publisher","first-page":"1634","DOI":"10.1136\/hrt.2007.132092","volume":"94","author":"BM Schaefer","year":"2008","unstructured":"Schaefer BM, Lewin MB, Stout KK et al (2008) The bicuspid aortic valve: an integrated phenotypic classification of leaflet morphology and aortic root shape. Heart 94:1634\u20131638","journal-title":"Heart"},{"key":"5775_CR21","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1161\/01.ATV.0000055441.28842.0A","volume":"23","author":"VT Nkomo","year":"2003","unstructured":"Nkomo VT, Enriquez-Sarano M, Ammash NM et al (2003) Bicuspid aortic valve associated with aortic dilatation: a community-based study. Arterioscler Thromb Vasc Biol 23:351\u2013356","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"5775_CR22","doi-asserted-by":"publisher","first-page":"III35","DOI":"10.1161\/01.CIR.102.suppl_3.III-35","volume":"102","author":"MG Keane","year":"2000","unstructured":"Keane MG, Wiegers SE, Plappert T, Pochettino A, Bavaria JE, Sutton MG (2000) Bicuspid aortic valves are associated with aortic dilatation out of proportion to coexistent valvular lesions. Circulation 102:III35\u2013III39","journal-title":"Circulation"},{"key":"5775_CR23","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/S0002-9149(03)00480-6","volume":"92","author":"GM Novaro","year":"2003","unstructured":"Novaro GM, Tiong IY, Pearce GL, Grimm RA, Smedira N, Griffin BP (2003) Features and predictors of ascending aortic dilatation in association with a congenital bicuspid aortic valve. Am J Cardiol 92:99\u2013101","journal-title":"Am J Cardiol"},{"key":"5775_CR24","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1016\/j.amjcard.2004.08.098","volume":"95","author":"M Cecconi","year":"2005","unstructured":"Cecconi M, Manfrin M, Moraca A et al (2005) Aortic dimensions in patients with bicuspid aortic valve without significant valve dysfunction. Am J Cardiol 95:292\u2013294","journal-title":"Am J Cardiol"},{"key":"5775_CR25","doi-asserted-by":"publisher","first-page":"972","DOI":"10.1161\/01.CIR.0000117405.74491.D2","volume":"109","author":"SJ Skaluba","year":"2004","unstructured":"Skaluba SJ, Litwin SE (2004) Mechanisms of exercise intolerance: insights from tissue Doppler imaging. Circulation 109:972\u2013977","journal-title":"Circulation"},{"key":"5775_CR26","doi-asserted-by":"crossref","unstructured":"Ibrahim el-SH, Johnson KR, Miller AB, Shaffer JM, White RD (2010) Measuring aortic pulse wave velocity using high-field cardiovascular magnetic resonance: comparison of techniques. J Cardiovasc Magn Reson 12:26","DOI":"10.1186\/1532-429X-12-26"},{"key":"5775_CR27","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1152\/jappl.1993.74.1.492","volume":"74","author":"RH Mohiaddin","year":"1993","unstructured":"Mohiaddin RH, Firmin DN, Longmore DB (1993) Age-related changes of human aortic flow wave velocity measured noninvasively by magnetic resonance imaging. J Appl Physiol (1985) 74:492\u2013497","journal-title":"J Appl Physiol (1985)"},{"key":"5775_CR28","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.ahj.2006.08.025","volume":"153","author":"A Nemes","year":"2007","unstructured":"Nemes A, Galema TW, Geleijnse ML et al (2007) Aortic valve replacement for aortic stenosis is associated with improved aortic distensibility at long-term follow-up. Am Heart J 153:147\u2013151","journal-title":"Am Heart J"},{"key":"5775_CR29","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1093\/ejechocard\/jeq002","volume":"11","author":"M Dalsgaard","year":"2010","unstructured":"Dalsgaard M, Kjaergaard J, Pecini R et al (2010) Predictors of exercise capacity and symptoms in severe aortic stenosis. Eur J Echocardiogr 11:482\u2013487","journal-title":"Eur J Echocardiogr"},{"key":"5775_CR30","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.echo.2009.01.007","volume":"22","author":"M Dalsgaard","year":"2009","unstructured":"Dalsgaard M, Kjaergaard J, Pecini R et al (2009) Left ventricular filling pressure estimation at rest and during exercise in patients with severe aortic valve stenosis: comparison of echocardiographic and invasive measurements. J Am Soc Echocardiogr 22:343\u2013349","journal-title":"J Am Soc Echocardiogr"},{"key":"5775_CR31","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1148\/radiol.09091437","volume":"255","author":"MD Hope","year":"2010","unstructured":"Hope MD, Hope TA, Meadows AK et al (2010) Bicuspid aortic valve: four-dimensional MR evaluation of ascending aortic systolic flow patterns. Radiology 255:53\u201361","journal-title":"Radiology"},{"key":"5775_CR32","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/1532-429X-12-4","volume":"12","author":"PM Reijer den","year":"2010","unstructured":"den Reijer PM, Sallee D 3rd, van der Velden P et al (2010) Hemodynamic predictors of aortic dilatation in bicuspid aortic valve by velocity-encoded cardiovascular magnetic resonance. J Cardiovasc Magn Reson 12:4","journal-title":"J Cardiovasc Magn Reson"},{"key":"5775_CR33","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1067\/mva.2003.40","volume":"37","author":"KA Wilson","year":"2003","unstructured":"Wilson KA, Lee AJ, Lee AJ et al (2003) The relationship between aortic wall distensibility and rupture of infrarenal abdominal aortic aneurysm. J Vasc Surg 37:112\u2013117","journal-title":"J Vasc Surg"},{"key":"5775_CR34","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1016\/j.avsg.2011.05.034","volume":"25","author":"J Molacek","year":"2011","unstructured":"Molacek J, Baxa J, Houdek K, Treska V, Ferda J (2011) Assessment of abdominal aortic aneurysm wall distensibility with electrocardiography-gated computed tomography. Ann Vasc Surg 25:1036\u20131042","journal-title":"Ann Vasc Surg"},{"key":"5775_CR35","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1093\/ehjci\/jeu121","volume":"15","author":"JN Khan","year":"2014","unstructured":"Khan JN, Wilmot EG, Leggate M et al (2014) Subclinical diastolic dysfunction in young adults with Type 2 diabetes mellitus: a multiparametric contrast-enhanced cardiovascular magnetic resonance pilot study assessing potential mechanisms. Eur Heart J Cardiovasc Imaging 15:1263\u20131269","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"5775_CR36","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1016\/j.amjcard.2006.09.118","volume":"99","author":"BM Schaefer","year":"2007","unstructured":"Schaefer BM, Lewin MB, Stout KK, Byers PH, Otto CM (2007) Usefulness of bicuspid aortic valve phenotype to predict elastic properties of the ascending aorta. Am J Cardiol 99:686\u2013690","journal-title":"Am J Cardiol"}],"container-title":["European Radiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-018-5775-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00330-018-5775-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-018-5775-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T19:10:14Z","timestamp":1574881814000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s00330-018-5775-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,28]]},"references-count":36,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["5775"],"URL":"https:\/\/doi.org\/10.1007\/s00330-018-5775-6","relation":{},"ISSN":["0938-7994","1432-1084"],"issn-type":[{"value":"0938-7994","type":"print"},{"value":"1432-1084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,28]]},"assertion":[{"value":"14 May 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 August 2018","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 September 2018","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 November 2018","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health, UK.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The scientific guarantor of this publication is Professor Gerry McCann.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"MAH is the owner of Xinapse Systems software which was used to quantify distensibility and PWV in this study. There are no other competing interests to declare.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"No complex statistical methods were necessary for this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was obtained from all subjects before participation.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The study was approved by the United Kingdom National Research Ethics Service (11\/EM\/0410).","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Some study subjects have been previously reported in the main results of the PRIMID-AS study (as mentioned in reference 15 under the \u201c\u201d section of the manuscript). However, the aortic stiffness parameters are novel in this manuscript, as is the comparison of bicuspid and tricuspid sub-groups.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohort overlaps"}},{"value":"\u2022 Prospective\u2022 Multi-centre\u2022 Observational study","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}