Evaluation of bicuspid aortic valve-associated aortopathic changes using third-generation dual-source computed tomography

Table 1 Baseline patient characteristics and bicuspid aortic valve morphology (n = 100), mean ± SD/n (%)

Characteristic	Value
Demographics
Age (year)	48.95 ± 13.78
Male gender	64 (64.0)
Anthropometric measurements
Height (cm)	164.08 ± 9.68
Weight (kg)	62.97 ± 10.51
BMI (kg/m2)	23.45 ± 3.73
BSA (m2)	1.72 ± 0.15
Clinical characteristics
Significant comorbidities1	21 (21.0)
Previous cardiac intervention	9 (9.0)
BAV morphology (Sievers classification)
Type 0 (no raphe)	63 (63.0)
Type 1 (one raphe)	37 (37.0)
Type 2 (two raphes)	0 (0.0)

¹Includes hypertension, type 2 diabetes mellitus, and coronary artery disease.

Body surface areas were calculated using the Dubois formula: Body surface area (m²) = 0.007184 × height (cm)^0.725 × weight (kg)^0.425. BMI: Body mass index; BSA: Body surface area; BAV: Bicuspid aortic valve.

Table 2 Aortic dimensions, aortic size index distribution, and aortopathic changes (n = 100), mean ± SD/n (%)

Parameter	Value
Aortic dimensions (mm)
Aortic annulus	25.43 ± 5.02
Sinus of Valsalva	34.55 ± 6.74
Ascending aorta	42.79 ± 8.69
Aortic arch	26.19 ± 4.77
Proximal descending thoracic aorta	22.81 ± 3.78
Descending thoracic aorta at hiatus	18.94 ± 2.80
Ascending aorta diameter categories (mm)
< 35	13 (13.0)
35-39	22 (22.0)
40-44	32 (32.0)
≥ 45	33 (33.0)
ASI (mm/m2)	25.13 ± 5.71
< 20 (low risk)	12 (12.0)
20-25 (moderate risk)	46 (46.0)
> 25 (high risk)	42 (42.0)
Aortopathic changes
Aortic dilatation > 40 mm	61 (61.0)
Aortic valve calcification	73 (73.0)
Aortic wall calcification	21 (21.0)
Aortic wall thickening > 4 mm	5 (5.0)
Aortic dissection (Stanford type A)	1 (1.0)
Aortic coarctation/narrowing	2 (2.0)

ASI: Aortic size index.

Table 3 Receiver operating characteristic characteristics of aortic size index and comparison with imaging modalities

Parameter	Value (95%CI)
ROC analysis for predicting aortic dilatation > 40 mm
ASI (cutoff ≥ 23.8 mm/m2)
AUROC	0.935 (0.891-0.979)
Sensitivity (%)	84 (72-92)
Specificity (%)	90 (76-97)
Positive predictive value (%)	92.7 (82-98)
Negative predictive value (%)	77.8 (63-89)
Diagnostic accuracy (%)	86 (78-92)
CT ascending aorta diameter (cutoff ≥ 40 mm)
AUROC	0.972 (0.942-1.000)
Sensitivity (%)	100 (94-100)
Specificity (%)	90 (76-97)
Diagnostic accuracy (%)	96 (90-99)
Echocardiography diameter (cutoff ≥ 34 mm)
AUROC	0.773 (0.633-0.912)
Sensitivity (%)	68 (48-84)
Specificity (%)	90 (67-99)
Diagnostic accuracy (%)	76.6 (62-88)
CT vs echocardiography agreement
Mean diameter difference (mm)	11.72 ± 8.27
Weighted Kappa coefficient	0.356 (fair agreement)

ROC: Receiver operating characteristic; ASI: Aortic size index; AUROC: Area under receiver operating characteristic curve; CT: Computed tomography.