{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:02Z","timestamp":1787018102891,"version":"build-2736575974"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,9,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Bicuspid aortic valve (BAV) is the most common congenital heart disease in adults but is clinically heterogeneous. We aimed to describe the echocardiographic characteristics of BAV and compare patients with BAV with moderate\u2010to\u2010severe aortic stenosis (AS) with those with tricuspid aortic valve (TAV) stenosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Using the National Echo Database of Australia, patients in whom BAV was identified were studied. Those with moderate\u2010to\u2010severe AS (mean gradient &gt;20\u00a0mm\u00a0Hg [BAV\u2010AS]) were compared with those with TAV and moderate\u2010to\u2010severe AS (TAV\u2010AS). Of 264\u00a0159 adults whose aortic valve morphology was specified, 4783 (1.8%) had confirmed BAV (aged 49.6\u00b117.4 years, 69% men). Of these, 42% had no AS, and 46% had no aortic regurgitation. Moderate\u2010to\u2010severe AS was detected in a greater proportion of patients with BAV with a recorded mean gradient (n=1112, 34%) compared with those with TAV (n=4377, 4%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Patients with BAV\u2010AS were younger (aged 55.3\u00b116.7\u00a0years versus 77.3\u00b111.0\u00a0years;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), and where measured had larger ascending aortic diameters (37\u00b18\u00a0mm versus 35\u00b15\u00a0mm;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Age and sex\u2010adjusted mortality risk was significantly lower in patients with BAV\u2010AS (hazard ratio, 0.53; 95% CI, 0.45\u20130.63;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this large study of patients across the spectrum of BAV disease, the largest proportion had no significant valvulopathy or aortopathy. Compared with those with TAV\u2010AS, patients with BAV were more likely to have moderate\u2010to\u2010severe AS, have larger ascending aortas, and were over 2 decades younger at the time of AS diagnosis. Despite this, patients with BAV appear to have a more favorable prognosis when AS develops, compared with those with TAV\u2010AS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.anzctr.org.au\/\">www.anzctr.org.au\/<\/jats:ext-link>\n                      ; Unique identifier: ACTRN12617001387314.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.121.020785","type":"journal-article","created":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T05:08:42Z","timestamp":1630127322000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Characteristics of Bicuspid Aortic Valve Disease and Stenosis: The National Echo Database of Australia"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6416-5566","authenticated-orcid":false,"given":"Michelle S.","family":"Lim","sequence":"first","affiliation":[{"name":"University of SydneySydney Medical SchoolFaculty of Medicine and Health Camperdown New South Wales Australia"},{"name":"Department of Cardiology Royal Prince Alfred Hospital Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6800-7119","authenticated-orcid":false,"given":"Geoff","family":"Strange","sequence":"additional","affiliation":[{"name":"University of SydneySydney Medical SchoolFaculty of Medicine and Health Camperdown New South Wales Australia"},{"name":"University of Notre Dame Fremantle Western Australia Australia"},{"name":"Heart Research Institute Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4492-1103","authenticated-orcid":false,"given":"David","family":"Playford","sequence":"additional","affiliation":[{"name":"University of Notre Dame Fremantle Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Stewart","sequence":"additional","affiliation":[{"name":"Torrens University Australia Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7640-0439","authenticated-orcid":false,"given":"David S.","family":"Celermajer","sequence":"additional","affiliation":[{"name":"University of SydneySydney Medical SchoolFaculty of Medicine and Health Camperdown New South Wales Australia"},{"name":"Department of Cardiology Royal Prince Alfred Hospital Camperdown New South Wales Australia"},{"name":"Heart Research Institute Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/heart.83.1.81"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(70)90761-7"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(77)80186-0"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2017-311560"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000155623.48408.C5"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004211"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2016-309916"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.08.004"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2018.07.001"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1286"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e3182764b84"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2019.06.496"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.75.2.174"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.014591"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.03.509"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jex211"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.112.973370"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2011.05.004"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.113.000528"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.25956"},{"key":"e_1_3_2_22_2","first-page":"797","article-title":"Wall 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Wall shear stress and flow patterns in the ascending aorta in patients with bicuspid aortic valves differ significantly from tricuspid aortic valves: a prospective study. Eur Heart J. 2013;14:797\u2013804.","journal-title":"Eur Heart J"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.11.1317"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.740878"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1912846"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.21037\/cdt.2017.05.03"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.041835"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.121.020785","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:42:18Z","timestamp":1715586138000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.121.020785"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,7]]},"references-count":26,"journal-issue":{"issue":"17","published-print":{"date-parts":[[2021,9,7]]}},"alternative-id":["10.1161\/JAHA.121.020785"],"URL":"https:\/\/doi.org\/10.1161\/jaha.121.020785","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,7]]},"assertion":[{"value":"2021-01-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e020785"}}