Aortic aneurysm is common in patients with coarctation of aorta (COA), but it is unclear whether the risk of aortic aneurysms is due to COA or related to the presence of other risk factors such as bicuspid aortic valve (BAV) and hypertension. The purpose of this study was to assess the relationship among COA, BAV, and thoracic aortic aneurysms. A total of 867 patients with COA (COA group) were matched 1:1:1 to 867 patients with isolated BAV (BAV group) and 867 patients without structural heart disease (SHD) (no-SHD group). The COA group was further subdivided into a COA+BAV subgroup (n = 304 [35%]), and COA with tricuspid aortic valve (TAV) (COA+TAV subgroup [n = 563 (65%)]). Aortic dimensions were assessed at baseline and at 3, 5, and 7 years. Compared with the no-SHD group, the COA+BAV subgroup had larger aortic root diameter (37 mm [Q1-Q3: 30-43 mm] vs 32 mm [Q1-Q3: 27-35 mm]; < 0.001) and mid ascending aorta dimeter (34 mm [Q1-Q3: 29-40 mm] vs 28 mm [Q1-Q3: 24-31 mm]; = 0.008). Similarly, the BAV group had larger aortic root diameter (37 mm [Q1-Q3: 30-42 mm] vs 32 mm [Q1-Q3: 27-35 mm]; < 0.001), and mid ascending aorta dimeter (35 mm [Q1-Q3: 30-40 mm] vs 28 mm [Q1-Q3: 24-31 mm]; < 0.001). Compared with the COA+TAV subgroup, the COA+BAV subgroup and BAV group were associated with larger aortic root and mid ascending aorta diameter at baseline and follow-up. The risk of acute aortic complications was low in all groups. These findings suggest that BAV (and not COA) was associated with ascending thoracic aorta dimensions, and that patients with COA+TAV were not at a greater risk of developing ascending aortic aneurysms as compared with patients without SHD.

中文翻译：

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主动脉缩窄伴三尖瓣主动脉瓣与升主动脉瘤无关

主动脉瘤在主动脉缩窄（COA）患者中很常见，但尚不清楚主动脉瘤的风险是由COA引起还是与二叶式主动脉瓣（BAV）和高血压等其他危险因素的存在有关。本研究的目的是评估 COA、BAV 和胸主动脉瘤之间的关系。将 867 例 COA 患者（COA 组）与 867 例孤立性 BAV 患者（BAV 组）和 867 例无结构性心脏病（SHD）患者（无 SHD 组）进行 1:1:1 匹配。 COA 组进一步细分为 COA+BAV 亚组（n = 304 [35%]）和带有三尖瓣主动脉瓣 (TAV) 的 COA（COA+TAV 亚组 [n = 563 (65%)]）。在基线以及第 3 年、第 5 年和第 7 年时评估主动脉尺寸。与无 SHD 组相比，COA+BAV 亚组的主动脉根部直径较大（37 mm [Q1-Q3：30-43 mm] vs 32 mm [Q1-Q3：27-35 mm]；< 0.001）升主动脉直径（34 毫米 [Q1-Q3：29-40 毫米] 与 28 毫米 [Q1-Q3：24-31 毫米]；= 0.008）。同样，BAV 组的主动脉根部直径较大（37 毫米[Q1-Q3：30-42 毫米] vs 32 毫米[Q1-Q3：27-35 毫米]；< 0.001），升主动脉中部直径（35 毫米[Q1-Q3：27-35 毫米]；< 0.001）。 Q1-Q3：30-40 毫米] 与 28 毫米[Q1-Q3：24-31 毫米]；< 0.001）。与COA+TAV亚组相比，COA+BAV亚组和BAV组在基线和随访时与较大的主动脉根部和升主动脉中部直径相关。所有组中急性主动脉并发症的风险均较低。这些结果表明，BAV（而不是 COA）与升主动脉尺寸相关，并且与没有 SHD 的患者相比，COA+TAV 患者发生升主动脉瘤的风险并不更大。