European Heart Journal Advance Access originally published online on December 20, 2007
European Heart Journal 2008 29(4):472-479; doi:10.1093/eurheartj/ehm528
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Aortic elasticity and size in bicuspid aortic valve syndrome
1 Cardiology Service—CMSR Veneto Medica, Via Vicenza, 204, Altavilla Vicentina (VI), 36077 Vicenza, Italy
2 Department of Bioengineering, Rice University, Houston, TX, USA
3 CNR, Aging Branch, Padua, Italy
4 Institute of Pathological Anatomy, Padua University, Padua, Italy
Received 18 March 2007; revised 21 October 2007; accepted 29 October 2007; online publish-ahead-of-print 20 December 2007.
* Corresponding author. Tel: +39 0444225111, Fax: +39 0444225199, Email: snistr{at}tin.it
See page 432 for the editorial comment on this article (doi:10.1093/eurheartj/ehm609)
Aims: To investigate the relation between aortic elastic properties and size in bicuspid aortic valves (BAVs).
Methods and results: 127 BAV outpatients (121 males; age 23 ± 10 years) with no or mild valvular impairment, were recruited with 114 control subjects comparable for age, gender, and body size. Aortic distensibility (DIS) and stiffness index (SI) were derived by M-mode evaluation of the aortic root together with blood pressure measured by cuff sphygmomanometer. BAVs vs. controls had increased aortic diameter (P < 0.0001), higher systolic (P = 0.02) and pulse (P = 0.04) pressures. DIS was lower in BAVs than in controls (4.71 ± 3.67 vs. 7.44 ± 3.94 10–6 cm2dyne–1, respectively; P < 0.0001) and SI was greater in BAVs (7.21 ± 4.93 vs. 3.57 ± 1.88, respectively; P < 0.0001). Definite impairment in aortic elasticity was present in 53 (42%) BAVs. Both DIS and SI were related (P < 0.0001) to aortic size in BAVs and controls. After adjusting for aortic size and blood pressure, the regression relations between SI and aortic diameter of BAVs were significantly different from controls (P = 0.0052).
Conclusion: Abnormal aortic elasticity is a common finding in BAVs with no or mild aortic valve impairment. However, impaired aortic stiffness is not due to aortic dilation. Simple assessment of aortic size may thus fail to identify early abnormal load bearing characteristics of the aortic wall in BAVs.
Key Words: Bicuspid aortic valve • Echocardiography • Aortic elasticity
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