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Background Bicuspid aortic valves (BAV) are associated with higher incidence of aortopathy such as aortic dilatation, dissection, and aortic valve stenosis. Recent 4D flow MRI studies have provided evidence that BAV aortopathy is associated with specific hemodynamic abnormalities and increased wall shear stress (WSS) which is thought to alter aortic endothelial cell function and induce remodeling and dilatation. Pharmacologic management of BAV is currently debated. It has been hypothesized that blood pressure control using medical therapy can decrease or reduce the rate of change to central arterial pressure and thus reduce wall forces such as wall shear stress (WSS) on the aneurysmal segment of the aorta to prevent aortic remodeling and dilatation. However, invivo studies investigating the effect of cardiac medications on aortic WSS in BAV patients are lacking. In this longitudinal follow-up 4D flow MRI study, the effects of Beta blockers (BB), Angiotensin converting enzyme inhibitors (ACEI), and Angiotensin II Receptor Blockers (ARB) on the aortic WSS was investigated using 4D Flow MRI.

Impact of Beta-blocker, ACE Inhibitor, and ARB therapy on thoracic aorta wall shear stress in bicuspid aortic valve patients