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Aortic elasticity and the influence of valve morphology in children with bicuspid aortic valve

Published online by Cambridge University Press:  06 August 2018

Elif Erolu ,
Figen Akalın ,
Nilüfer Çetiner  and
Berna Ç. Şaylan
Elif Erolu*
Affiliation:
Divisions of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Marmara University, Istanbul, Turkey
Figen Akalın
Affiliation:
Divisions of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Marmara University, Istanbul, Turkey
Nilüfer Çetiner
Affiliation:
Divisions of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Marmara University, Istanbul, Turkey
Berna Ç. Şaylan
Affiliation:
Divisions of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Marmara University, Istanbul, Turkey
*
Author for correspondence: Elif Erolu, Divisions of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Marmara University Fevzi Çakmak Mah. Muhsin Yazıcıoğlu Cad. No: 10 Üst Kaynarca, Pendik, Istanbul, Turkey. Tel: +90 505 816 9456; Fax: +90 216 625 4639; E-mail: [email protected]
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Abstract

Aim

We investigated dimensions and elasticity of whole aorta in patients with bicuspid aortic valve and influence of valve phenotype.

Method

The study group included 44 patients and 42 controls. Patients were divided into groups according to the type of valve opening as horizontal – fusion between right and left coronary cusps – and vertical – fusion between right–non-coronary cusps; according to age they were divided into younger (5–10 years) and older patients (11–16 years). Our study did not include valve phenotype with fusion between left and non-coronary cusps. Systolic–diastolic diameters of aortic annulus, sinus valsalva, sinutubular junction, arcus, and ascending–descending and abdominal aorta were measured and z-scores were obtained. Aortic strain, distensibility, and stiffness index were calculated. Flow-mediated dilatation of brachial artery was studied.

Results

z-Scores at annulus, sinus valsalva, sinutubular junction, and ascending aorta were higher in study patients (p=0.001, p=0.0001, p=0.0001, p=0.0001, respectively). z-Scores of sinus valsalva and sinotubular junction were higher in the horizontal group than in the vertical group (p=0.006, p=0.023, respectively). z-Score was over +2 in 51% of patients with horizontal morphology and 33% of patients with vertical morphology (p=0.0001). Ascending aorta was more distensible and less stiff in the study group (11.3±5.63 versus 7.91±4.5, p=0.002; 4.76±3.60 versus 6.19±3.44 cm2.dyn−1.10−6, p=0.033, respectively). Stiffness index of ascending, arcus, and abdominal aorta were higher in the horizontal group (p=0.004, p=0.038, p=0.006, respectively). Ascending aorta was more distensible and less stiff in the younger group (p=0.007, p=0.027, respectively) but did not differ in the older group compared with the control group.

Conclusion

Aortic dimensions are enlarged in patients with bicuspid aortic valve starting from childhood, suggesting the presence of generalised aortopathy. Aortic elasticity is increased at young age and decreased with age.

Keywords

Bicuspid aortic valvechildrenaortic distensibilityaortic stiffnessflow-mediated dilatation
Type
Original Article
Information
Cardiology in the Young , Volume 28 , Issue 11 , November 2018 , pp. 1338 - 1344
Copyright
© Cambridge University Press 2018 

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