Research Information System
Journal of Heart Valve Disease, vol.21, no.2, pp.189-194, 2012 (SCI-Expanded, Scopus)
Background and aim of the study: Bicuspid aortic valve (BAV) is one of the most common congenital heart defects. BAV disease is not only a disorder of valvulogenesis, but also represents a genetic disorder of aorta and cardiac development. Recent studies have shown that BAV is associated with abnormal aortic elasticity, and that a reduced distensibility of the aortic root may have a negative impact on left ventricular function. Hence, the study aim was to investigate left ventricular diastolic function and its relationship to aortic elasticity in this patient group. Methods: Thirty-nine patients with isolated BAV with a normal left ventricular ejection fraction, and 29 age- and gender-matched healthy (control) subjects, were studied prospectively. In none of the patients with BAV was the aortic velocity >2m/s, and no aortic regurgitation (other than mild) was present. Parameters of aortic elasticity (aortic strain, distensibility index, stiffness index and elastic modulus), left ventricular diastolic parameters (E, A, E/a, deceleration time, E′, ratio of E/E′, left atrial volume index) and valvulo-arterial impedance were calculated in all patients. Results: Aortic strain and distensibility were lower, and aortic stiffness index and aortic modulus higher, in patients with BAV than in controls. Compared to controls, the E/E′ ratio and left atrial volume index were significantly higher in BAV patients (E/E′ ratio 8.26 ± 2.56 versus 6.85 ± 1.45, p = 0.01; left atrium volume index 24.23 ± 5.78 versus 21.68 ± 4.11 ml/m2, p = 0.04). However, no significant correlations were identified between the aortic elasticity parameters, valvulo-arterial impedance, and left ventricular diastolic parameters. Conclusion: These findings indicated that BAV is associated with an increased left atrial volume and a decreased E/E′ ratio. In addition, these parameters did not correlate with any parameters of aortic elasticity, nor valvulo-arterial impedance. These data suggest that BAV disease might have subclinical cardiac dysfunction, and further studies are required to confirm these findings and any causal relationship. © Copyright by ICR Publishers 2012.