{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:55:30Z","timestamp":1789556130064,"version":"build-2803163510"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T00:00:00Z","timestamp":1602028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Bicuspid aortic valve (BAV) may be complicated by aortic aneurysms and dissection. This study aimed to evaluate the prognostic efficacy of markers from cardiac imaging, as well as genetic and new biomarkers, to early predict aortic complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We re-evaluated after a mean time of 48\u2009\u00b1\u200911\u2009months 47 BAV patients who had undergone previous echocardiography for evaluation of aortic stiffness and 2D aortic longitudinal strain (LS) (by speckle-tracking analysis), and who had given a blood sample for the assessment of a single-nucleotide polymorphism of elastin gene (ELN rs2 071307) and quantification of elastin soluble fragments (ESF). Surgical treatment of aortic aneurysm\/dissection was the primary endpoint, and an aortic dimension increase (of one or more aortic segments) \u22651\u2009mm\/year was the secondary endpoint. Nine patients underwent surgical treatment of ascending aorta (AA) aneurysms. Out of the 38 patients who did not need surgical intervention, 16 showed an increase of aortic root and\/or AA dimension \u22651\u2009mm\/year. At multivariate Cox regression analysis, an impaired AA LS was an independent predictor of aortic surgery [P\u2009=\u20090.04; hazard ratio (HR) 0.961; 95% confidence interval (CI) 0.924\u20130.984] and aortic dilatation (P\u2009=\u20090.007; HR 0.960; 95% CI 0.932\u20130.989). An increased quantity of ESF was correlated (P\u2009=\u20090.015) with the primary endpoint at univariate Cox regression analysis but it did not keep statistical significance at multivariate analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In BAV patients, impairment of elastic properties of the AA, as assessed by 2D LS, is an effective predictor of aortic complications.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeaa250","type":"journal-article","created":{"date-parts":[[2020,8,12]],"date-time":"2020-08-12T03:37:10Z","timestamp":1597203430000},"page":"808-816","source":"Crossref","is-referenced-by-count":20,"title":["Bicuspid aortic valve and aortopathy: novel prognostic predictors for the identification of high-risk patients"],"prefix":"10.1093","volume":"22","author":[{"given":"Luca","family":"Longobardo","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine - Section of Cardiology, University of Messina, Azienda Ospedaliera Universitaria \u2018Policlinico G. Martino\u2019 and Universit\u00e0 degli Studi di Messina, Via Consolare Valeria n.12, 98100 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scipione","family":"Carerj","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine - Section of Cardiology, University of Messina, Azienda Ospedaliera Universitaria \u2018Policlinico G. Martino\u2019 and Universit\u00e0 degli Studi di Messina, Via Consolare Valeria n.12, 98100 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Bitto","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine - Section of Pharmacology, University of Messina, Azienda Ospedaliera Universitaria \u2018Policlinico G. Martino\u2019 and Universit\u00e0 degli Studi di Messina, Via Consolare Valeria n.12, 98100 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Cusm\u00e0-Piccione","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine - Section of Cardiology, University of Messina, Azienda Ospedaliera Universitaria \u2018Policlinico G. Martino\u2019 and Universit\u00e0 degli Studi di Messina, Via Consolare Valeria n.12, 98100 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Ludovica","family":"Carerj","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Morphological and Functional Imaging - Section of Radiological Sciences, Azienda Ospedaliera Universitaria \u2018Policlinico G. Martino\u2019 and Universit\u00e0 degli Studi di Messina, Via Consolare Valeria n.12, 98100 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Pia","family":"Calabr\u00f2","sequence":"additional","affiliation":[{"name":"Department of Human Pathology of Adulthood and Childhood - Section of Pediatric Cardiology, Azienda Ospedaliera Universitaria \u2018Policlinico G. Martino\u2019 and Universit\u00e0 degli Studi di Messina, Via Consolare Valeria n.12, 98100 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Di Bella","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine - Section of Cardiology, University of Messina, Azienda Ospedaliera Universitaria \u2018Policlinico G. Martino\u2019 and Universit\u00e0 degli Studi di Messina, Via Consolare Valeria n.12, 98100 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Licordari","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine - Section of Cardiology, University of Messina, Azienda Ospedaliera Universitaria \u2018Policlinico G. Martino\u2019 and Universit\u00e0 degli Studi di Messina, Via Consolare Valeria n.12, 98100 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Squadrito","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine - Section of Pharmacology, University of Messina, Azienda Ospedaliera Universitaria \u2018Policlinico G. Martino\u2019 and Universit\u00e0 degli Studi di Messina, Via Consolare Valeria n.12, 98100 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7931-0858","authenticated-orcid":false,"given":"Bijoy K","family":"Khandheria","sequence":"additional","affiliation":[{"name":"Aurora Cardiovascular and Thoracic Services, Aurora Sinai\/Aurora St. Luke\u2019s Medical Centers, University of Wisconsin School of Medicine and Public Health, Marcus Family Fund for Echocardiography (ECHO) Research and Education, 2801 W. Kinnickinnic River Parkway, #880, Milwaukee, WI 53215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concetta","family":"Zito","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine - Section of Cardiology, University of Messina, Azienda Ospedaliera Universitaria \u2018Policlinico G. Martino\u2019 and Universit\u00e0 degli Studi di Messina, Via Consolare Valeria n.12, 98100 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,10,7]]},"reference":[{"key":"2021062219591701400_jeaa250-B1","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/B978-1-4160-5892-2.00011-8","volume-title":"Valvular Heart Disease: A Companion to Braunwald\u2019s Heart Disease","author":"Braverman","year":"2009"},{"key":"2021062219591701400_jeaa250-B2","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1016\/j.amjmed.2016.03.009","article-title":"Bicuspid aortic valve: unlocking the morphogenetic puzzle","volume":"129","author":"Longobardo","year":"2016","journal-title":"Am J Med"},{"key":"2021062219591701400_jeaa250-B3","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.1093\/eurheartj\/ehx391","article-title":"ESC\/EACTS guidelines for the management of valvular heart disease","volume":"38","author":"Baumgartner","year":"2017","journal-title":"Eur Heart J"},{"key":"2021062219591701400_jeaa250-B4","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.jacc.2017.03.011","article-title":"AHA\/ACC Focused Update of the 2014 AHA\/ACC Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"70","author":"Nishimura","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2021062219591701400_jeaa250-B5","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1161\/CIRCULATIONAHA.107.702720","article-title":"Aortic diameter \u22655.5 cm is not a good predictor of type A aortic dissection: observations from the International Registry of Acute Aortic Dissection (IRAD)","volume":"116","author":"Pape","year":"2007","journal-title":"Circulation"},{"key":"2021062219591701400_jeaa250-B6","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1016\/j.ejcts.2008.12.047","article-title":"Aortic size in acute type A dissection: implications for preventive ascending aortic replacement","volume":"35","author":"Parish","year":"2009","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021062219591701400_jeaa250-B7","first-page":"83","article-title":"The genetic and molecular basis of bicuspid aortic valve associated thoracic aortopathy: a link to phenotype heterogeneity","volume":"2","author":"Padang","year":"2013","journal-title":"Ann Cardiothorac Surg"},{"key":"2021062219591701400_jeaa250-B8","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1093\/cvr\/cvt040","article-title":"Biomechanical factors in the biology of aortic wall and aortic valve diseases","volume":"99","author":"Back","year":"2013","journal-title":"Cardiovasc Res"},{"key":"2021062219591701400_jeaa250-B9","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1093\/ehjci\/jex224","article-title":"Impairment of elastic properties of the aorta in bicuspid aortic valve: relationship between biomolecular and aortic strain patterns","volume":"19","author":"Longobardo","year":"2018","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2021062219591701400_jeaa250-B10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"key":"2021062219591701400_jeaa250-B11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ejechocard\/jen303","article-title":"Echocardiographic assessment of valve stenosis: EAE\/ASE recommendations for clinical practice","volume":"10","author":"Baumgartner","year":"2009","journal-title":"Eur J Echocardiogr"},{"key":"2021062219591701400_jeaa250-B12","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1093\/ehjci\/jet105","article-title":"Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging","volume":"14","author":"Lancellotti","year":"2013","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2021062219591701400_jeaa250-B13","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1016\/j.jacc.2016.06.025","article-title":"Risk of aortic dissection in the moderately dilated ascending aorta","volume":"68","author":"Kim","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2021062219591701400_jeaa250-B14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/8979407","article-title":"Ten years of 2D longitudinal strain for early myocardial dysfunction detection: a clinical overview","volume":"2018","author":"Zito","year":"2018","journal-title":"Biomed Res Int"},{"key":"2021062219591701400_jeaa250-B15","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1093\/ehjci\/jex059","article-title":"Left atrium in heart failure with preserved ejection fraction: the importance of function before anatomy","volume":"18","author":"Longobardo","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2021062219591701400_jeaa250-B16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ehjci\/jet116","article-title":"Role of imaging in assessment of atrial fibrosis in patients with atrial fibrillation: state-of-the-art review","volume":"15","author":"Longobardo","year":"2014","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2021062219591701400_jeaa250-B17","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1093\/eurheartj\/ehm528","article-title":"Aortic elasticity and size in bicuspid aortic valve syndrome","volume":"29","author":"Nistri","year":"2008","journal-title":"Eur Heart J"},{"key":"2021062219591701400_jeaa250-B18","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.amjcard.2006.01.096","article-title":"Progression rate of ascending aortic dilation in patients with normally functioning bicuspid and tricuspid aortic valves","volume":"98","author":"La Canna","year":"2006","journal-title":"Am J Cardiol"},{"key":"2021062219591701400_jeaa250-B19","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/S1078-5884(97)80219-5","article-title":"Serum-elastin-peptides as a predictor of expansion of small abdominal aortic aneurysms","volume":"14","author":"Lindholt","year":"1997","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2021062219591701400_jeaa250-B20","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1053\/ejvs.2001.1329","article-title":"Five-year results of elastin and collagen markers as predictive tools in the management of small abdominal aortic aneurysms","volume":"21","author":"Lindholt","year":"2001","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2021062219591701400_jeaa250-B21","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1053\/ejvs.2001.1516","article-title":"Serum elastin peptides in the preoperative evaluation of abdominal aortic aneurysms","volume":"22","author":"Lindholt","year":"2001","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2021062219591701400_jeaa250-B22","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1111\/j.1540-8175.2008.00725.x","article-title":"A novel approach to assess aortic stiffness related to changes in aging using a two-dimensional strain imaging","volume":"25","author":"Oishi","year":"2008","journal-title":"Echocardiography"},{"key":"2021062219591701400_jeaa250-B23","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1016\/j.athoracsur.2013.06.037","article-title":"Method for aortic wall strain measurement with three-dimensional ultrasound speckle tracking and fitted finite element analysis","volume":"96","author":"Karatolios","year":"2013","journal-title":"Ann Thorac Surg"},{"key":"2021062219591701400_jeaa250-B24","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.echo.2013.12.013","article-title":"Elastic properties of the descending aorta in patients with a bicuspid or tricuspid aortic valve and aortic valvular disease","volume":"27","author":"Petrini","year":"2014","journal-title":"J Am Soc Echocardiogr"}],"container-title":["European Heart Journal - Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/22\/7\/808\/38813496\/jeaa250.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/22\/7\/808\/38813496\/jeaa250.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T19:59:50Z","timestamp":1624391990000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article\/22\/7\/808\/5918834"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,7]]},"references-count":24,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020,10,7]]},"published-print":{"date-parts":[[2021,6,22]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjci\/jeaa250","relation":{},"ISSN":["2047-2404","2047-2412"],"issn-type":[{"value":"2047-2404","type":"print"},{"value":"2047-2412","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,7,1]]},"published":{"date-parts":[[2020,10,7]]}}}