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Aortic and left ventricular remodeling in patients with bicuspid aortic valve without significant valvular dysfunction: A prospective study.
MedLine Citation:
PMID:  21315467     Owner:  NLM     Status:  Publisher    
BACKGROUND: Bicuspid aortic valve (BAV) represents the most common cardiac congenital malformation in the adult age. It is frequently associated with dilatation, aneurysm and dissection of the ascending aorta. The purpose of the following study was to evaluate in patients with BAV: 1) the elastic properties of the ascending aorta, 2) the mechanical function of the left ventricle and 3) stiffness, elasticity and strain of the epi-aortic vessels wall. METHODS: Forty BAV patients (28M/12F; age 20.9±4.7years; range 17-26) with no or mild valvular impairment were recruited with 40 control subjects (25M/15F; age 23.4±3.4years; range 15-31) matched for age, gender and body surface area (BSA). Aortic strain, aortic distensibility (AoDIS) and aortic stiffness index (AoSI) were derived. Left ventricular strain was acquired. Elastic properties of epi-aortic vessels were evaluated. RESULTS: BAVs vs. controls had increased systolic and diastolic aortic diameters (p<0.001). Aortic strain (%) was lower in BAVs than in controls (8.3±3.6 vs. 11.2±2.6; p<0.001) as well as AoDIS (10(-6)cm(2)dyn(-1)) (6.5±2.8 vs. 8.8±2.9; p=0.002), while AoSI was greater in BAVs (6.4±3.5 vs. 3.9±1.2; p<0.001). Both AoDIS and aortic strain were related to aortic size in BAVs and controls. Left ventricular longitudinal (p=0.01), circumferential (p=0.01) and radial (p<0.001) strain (%) were lower in BAVs. No significant differences were found in elastic properties of epi-aortic vessels. CONCLUSIONS: Bicuspid aortic valve is associated with an increased aortic stiffness and with a reduction of the aortic and left ventricular deformation properties. Epi-aortic vessels do not seem to be interested by the disease. The use of an echocardiographic method that can estimate the degree of aortic and left ventricular remodeling can provide great benefits in the selection of patients with BAV to be treated and in determining the time for beginning drug therapy.
Giuseppe Santarpia; Giancarlo Scognamiglio; Giovanni Di Salvo; Michele D'Alto; Berardo Sarubbi; Emanuele Romeo; Ciro Indolfi; Maurizio Cotrufo; Raffaele Calabrò
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-9
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Cardiology Department, Magna Graecia University, Catanzaro, Italy; Cardiology Department, Monaldi Hospital, Second University of Naples, Naples, Italy.
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