{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:18:39Z","timestamp":1790659119845,"version":"4.1.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Bicuspid aortic valve (BAV) is the most prevalent congenital heart defect affecting 1% to 2% of the population. It is associated with ascending aorta dilatation. Valve morphology, aortic stenosis (AS), and aortic insufficiency (AI) have been proposed as potential risk factors; however, evaluating their role is difficult, as these factors are inherently related. The aim of this study was to determine whether BAV morphology and dysfunction are independent determinants for ascending aorta dilatation in pediatric patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>A multicenter, retrospective, cross-sectional study of pediatric BAV patients followed since 2004 was performed. Imaging data were assessed for BAV morphology, severity of AS and AI, history of coarctation, and aortic dimensions. Associations were determined using multivariable regression analysis. A subset of patients undergoing aortic interventions (balloon dilation or Ross) were assessed longitudinally.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Data were obtained from 2122 patients (68% male; median age 10.2 years). Fifty percent of patients had ascending aorta dilatation. Right and noncoronary cusp fusion, increasing AS and AI, and older age were independently associated with ascending aorta dilatation. A history of coarctation was associated with less ascending aorta dilatation. In patients with neither AS nor AI, 37% had ascending aorta dilatation (4% severe). No complications related to aortic dilatation occurred in this cohort. Aortic\n              <jats:italic>Z<\/jats:italic>\n              scores were determined, and a\n              <jats:italic>Z<\/jats:italic>\n              -score calculator was created for this population.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In this large pediatric cohort of patients with BAV, valve morphology, AS, and AI are independently associated with ascending aorta dilatation, suggesting that hemodynamic factors influence aortopathy. However, even in BAVs with no AS or AI, there is significant ascending aorta dilatation independent of valve morphology. Interventions that led to changes in degree of AI and AS did not seem to influence change in aortic dimensions. The current BAV cohort can be used as a reference group for expected changes in aortic dimensions during childhood.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.119.009717","type":"journal-article","created":{"date-parts":[[2020,3,17]],"date-time":"2020-03-17T09:00:26Z","timestamp":1584435626000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Predictors of Bicuspid Aortic Valve\u2013Associated Aortopathy in Childhood"],"prefix":"10.1161","volume":"13","author":[{"given":"Michael","family":"Grattan","sequence":"first","affiliation":[{"name":"Department of Paediatrics, LHSC Children\u2019s Hospital, University of Western Ontario, London, Canada (M.G.)."},{"name":"Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Canada (M.G., R.K.R., C.M., S.M., Ch.-P.S.F., C.M., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Prince","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Universit\u00e9 de Montr\u00e9al, Canada (A.P., G.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rawan K.","family":"Rumman","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Canada (M.G., R.K.R., C.M., S.M., Ch.-P.S.F., C.M., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conall","family":"Morgan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Canada (M.G., R.K.R., C.M., S.M., Ch.-P.S.F., C.M., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Petrovic","sequence":"additional","affiliation":[{"name":"Division of Cardiology, The Hospital for Sick Children, Toronto, Canada (M.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Hauck","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, Ann &amp; Robert Lurie Children\u2019s Hospital of Chicago, Northwestern University, Chicago, IL (A.H., L.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana","family":"Young","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, Ann &amp; Robert Lurie Children\u2019s Hospital of Chicago, Northwestern University, Chicago, IL (A.H., L.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Franco-Cereceda","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden (A.F.-C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart","family":"Loeys","sequence":"additional","affiliation":[{"name":"Center for Medical Genetics, University of Antwerp\/Antwerp University Hospital, Belgium (B.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salah A.","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Thoracic Vascular Surgery, Universitaetsklinikum Schleswig-Holstein, Campus Luebeck, Germany (S.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"Dietz","sequence":"additional","affiliation":[{"name":"Medicine, Pediatrics, and Molecular Biology and Genetics, Johns Hopkins University School of Medicine\/HHMI, Baltimore, MD (H.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Mital","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Canada (M.G., R.K.R., C.M., S.M., Ch.-P.S.F., C.M., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Po Steve","family":"Fan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Canada (M.G., R.K.R., C.M., S.M., Ch.-P.S.F., C.M., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cedric","family":"Manlhiot","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Canada (M.G., R.K.R., C.M., S.M., Ch.-P.S.F., C.M., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Andelfinger","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, 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