The objective of this study was to examine similarities and differences in Caucasian and African-American patients with Bicuspid Aortic Valve (BAV) with respect to morphology, severity of aortic stenosis/insufficiency, and aortic dilatation.
Bicuspid aortic valve is a common congenital valve abnormality accounting for a large number of valve replacements.
229 patients with the diagnostic code “BAV” were identified retrospectively from our computerized adult echocardiographic database consisting of 91,896 studies performed at the University of Chicago Medical Center from 1998–2009, entailing 40.878 patients. Of those, 183 patients with BAV were included in this retrospective BAV single center cohort study, and reanalyzed with a comprehensive assessment of aortic dimensions, aortic valve morphology and function, clinical cardiovascular risk factors and patient characteristics.
Of the 183 patients with BAV, 138 were Caucasians (C) and 45 were African Americans (AA). Our Echo database encompasses approximately 65% AA, 31% C and 4% other races, for an estimated frequency of BAV in AA of 0.17 % and a frequency of BAV in C of 1.1 % (p=0.001). There were no significant inter-racial differences regarding gender, height, weight, hyperlipidemia, diabetes, tobacco use, cardiac medications, and left ventricular ejection fraction. The AA cohort was older (50±17 vs. 43±17, p<0.05) and had a higher prevalence of hypertension (51% vs. 24%, p <0.05). After adjusting for comorbidities, aortic dimensions were larger in C (C vs. AA: annulus 2.4±0.4 vs. 2.1±0.4, sinuses of Valsalva 3.4±0.7 vs. 3.1±0.6, sino-tubular junction 3.0±0.6 vs. 2.6±0.5, and ascending aorta 3.5±0.7 vs. 3.2±0.5, all p<0.05).
This is the first study to report racial differences among patient with BAV with reduced aortic dimensions in AA despite the presence of more risk factors, suggestive of marked heterogeneity in the BAV population, and indicating race as a potential disease modifier in BAV.