{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T01:50:47Z","timestamp":1789264247433,"version":"build-2803163510"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>In patients with bicuspid aortic valve and dilated proximal ascending aorta, we sought to assess (1) factors associated with increased longer-term cardiovascular mortality and (2) incremental prognostic use of indexing aortic root to patient height.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We studied 969 consecutive bicuspid aortic valve patients (50\u00b113 years; 87% men) with proximal aorta \u22654 cm, who also had a gated contrast-enhanced thoracic computed tomography or magnetic resonance angiography. A ratio of ascending aortic area\/height was calculated on tomography, and \u226510 cm\n              <jats:sup>2<\/jats:sup>\n              \/m was considered abnormal, as previously reported. Society of Thoracic Surgeons score and cardiovascular death were recorded. Greater than or equal to III+ aortic regurgitation and severe aortic stenosis were seen in 37% and 10%, respectively. Society of Thoracic Surgeons score and right ventricular systolic pressure were 2\u00b13 and 15\u00b116 mm Hg, respectively. Abnormal ascending aortic area\/height ratio was noted in 33%; 44% underwent ascending aortic surgery at 34 days. At 10.8 years (interquartile range, 9.6\u201312.3), 82 (9%) died (0.4% in-hospital postoperative mortality). On multivariable Cox survival analysis, ascending aortic area\/height ratio (hazard ratio, 2; 95% confidence interval, 1.20\u20133.35) was associated with cardiovascular death, whereas aortic surgery (hazard ratio, 0.46; confidence interval, 0.26\u20130.80) was associated with improved survival (both\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01). Of the 405 patients with ascending aortic diameter of 4.5 to 5.5 cm, 64% had an abnormal ascending aortic area\/height ratio, and 70% deaths occurred in patients with an abnormal ratio.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In bicuspid aortic valve patients with dilated proximal ascending aorta, ascending aortic area\/height ratio was independently associated with cardiovascular death.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.116.006249","type":"journal-article","created":{"date-parts":[[2017,6,8]],"date-time":"2017-06-08T01:05:16Z","timestamp":1496883916000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":61,"title":["Aortic Cross-Sectional Area\/Height Ratio and Outcomes in Patients With Bicuspid Aortic Valve and a Dilated Ascending Aorta"],"prefix":"10.1161","volume":"10","author":[{"given":"Ahmad","family":"Masri","sequence":"first","affiliation":[{"name":"From the Bicuspid Aortic Valve Center, Heart and Vascular Institute, Cleveland Clinic, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidyasagar","family":"Kalahasti","sequence":"additional","affiliation":[{"name":"From the Bicuspid Aortic Valve Center, Heart and Vascular Institute, Cleveland Clinic, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars G.","family":"Svensson","sequence":"additional","affiliation":[{"name":"From the Bicuspid Aortic Valve Center, Heart and Vascular Institute, Cleveland Clinic, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Alashi","sequence":"additional","affiliation":[{"name":"From the Bicuspid Aortic Valve Center, Heart and Vascular Institute, Cleveland Clinic, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Schoenhagen","sequence":"additional","affiliation":[{"name":"From the Bicuspid Aortic Valve Center, Heart and Vascular Institute, Cleveland Clinic, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric E.","family":"Roselli","sequence":"additional","affiliation":[{"name":"From the Bicuspid Aortic Valve Center, Heart and Vascular Institute, Cleveland Clinic, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas R.","family":"Johnston","sequence":"additional","affiliation":[{"name":"From the Bicuspid Aortic Valve Center, Heart and Vascular Institute, Cleveland Clinic, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Leonardo","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"From the Bicuspid Aortic Valve Center, Heart and Vascular Institute, Cleveland Clinic, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian P.","family":"Griffin","sequence":"additional","affiliation":[{"name":"From the Bicuspid Aortic Valve Center, Heart and Vascular Institute, Cleveland Clinic, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milind Y.","family":"Desai","sequence":"additional","affiliation":[{"name":"From the Bicuspid Aortic Valve Center, Heart and Vascular Institute, Cleveland Clinic, 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