IMAGING
There were 47 patients with echo and advanced imaging data. Thirty patients (64%) had AoD at the level of the sinuses of Valsalva by echocardiography. Thirty-seven patients (77%) had MR and 11 patients (23%) had CT performed. BAV (n=19) were started on medications at a diameter of 35mm [IQR: 29, 42] at the SoV and 34.5 mm [IQR: 30, 44] at the AAo. The median Z-score for patients with BAV at the SoV was 2.77 [IQR: 1.9, 4.3] and at the AAo was 5.38 [IQR: 3.4, 6.6]. Patients with genetic syndromes (MFS [n=13], LDS [n=2], TS [n=2]) were started on medication at the median diameter of 32 mm [IQR: 28, 36] at the SoV and 27 mm at the AAo [IQR: 25, 30]. The median Z-score for patients with genetic syndromes at the SoV was 2.96 [IQR: 1.9, 4.9] and at the AAo was 1.95 [IQR: 0.8, 3.7]. Patients without a genetic diagnosis and isolated AoD (n=10) were started on medications at a diameter of 34 mm [IQR: 31, 37] at the SoV and 27 mm [IQR: 24, 33] at the AAo. The median Z-score for patients with isolated AoD at the SoV was 3.13 [IQR: 2.2, 4.8] and at the AAo was 1.75 [IQR: -0.1, 2.6].
Based on Pearson correlation coefficient analysis, diameters between echocardiography and MR were relatively well correlated at the SoV and AAo. Echocardiographic and CT diameters at the SoV were also well correlated (Table 3). Echo SoV and AAo Z-scores were plotted by age and diagnosis at initiation of medication (Figures 1). The Kruskal-Wallis test show that the median Z-score differed by diagnosis for AAo (p = 0.013), but not for SoV (p = 0.604). A Dunn’s post-hoc test revealed that the BAV group had significantly higher AAo Z-scores than MFS (p = 0.045). B-A analysis and distribution plots were used to compare diameters obtained by echocardiography and advanced imaging modalities. Thirty-six (36) patients were included in B-A analysis for Echo vs. MR at the SoV and nineteen (19) patients were included for Echo vs. MR at the AAo. Ten (10) patients were included in the B-A analysis for Echo vs. CT at the SoV (Figures 2).