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Elastic properties of the abdominal aorta in the children with bicuspid aortic valve: an observational study
Dolunay Gürses1, Arif Ruhi Ozyürek, Ertürk Levent
1Department of Pediatric Cardiology, Faculty of Medicine, Pamukkale University, Denizli-Turkey. dolunayk@yahoo.com
Insights
Children with bicuspid aortic valve (BAV) have increased abdominal aortic stiffness. This stiffness is not caused by aortic dilation, suggesting a distinct vascular issue in pediatric BAV patients.
Area of Science:
- Cardiovascular Research
- Pediatric Cardiology
- Vascular Biology
Background:
- Bicuspid aortic valve (BAV) is frequently associated with abnormalities in the aortic root and ascending aorta.
- Understanding vascular changes in pediatric BAV patients is crucial for early detection and management.
Purpose of the Study:
- To investigate the stiffness of the abdominal aorta in children diagnosed with bicuspid aortic valve (BAV).
- To determine if abdominal aortic elasticity is affected in pediatric BAV patients.
Main Methods:
- A cross-sectional observational study involving 35 children with BAV and 35 healthy controls.
- Noninvasive transthoracic echocardiography was used to measure aortic diameters and calculate parameters of aortic stiffness.
- Statistical analyses included Student's t-test, Chi-square test, Pearson's correlation, and multivariate linear regression.
Main Results:
- Children with BAV showed significantly higher aortic stiffness (lower strain and distensibility; higher elastic modulus and stiffness index) compared to controls.
- Abdominal aortic diameters were similar between BAV patients and controls.
- No correlation was found between abdominal aortic diameter and aortic elasticity parameters.
Conclusions:
- Bicuspid aortic valve is linked to increased abdominal aortic stiffness in children.
- Impaired abdominal aortic elasticity in pediatric BAV is not a result of aortic dilation.
- Further research is needed to validate these findings on abdominal aortic stiffness in pediatric BAV.
Objective:
Abnormalities of the aortic root and ascending aorta are common in patients with a bicuspid aortic valve (BAV). The aim of this study was to evaluate the stiffness of the abdominal aorta in children with BAV.
Methods:
In this cross-sectional observational study, we evaluated 35 children with normally functioning or mildly regurgitant BAV and 35 healthy children as controls. All children were noninvasively evaluated with transthoracic echocardiography. Annulus of aorta and abdominal aorta diameters were measured. Aortic strain (S), pressure strain elastic modulus (Ep), pressure strain normalized by diastolic pressure (Ep*), aortic stiffness β index (βSI) and, aortic distensibility (DIS) were calculated using the measured data. In evaluation of the data Student's t-test, Chi-square test, Pearson's correlation and multivariate linear regression analysis were used.
Results:
Diameter of the aortic annulus was found significantly larger in the children with BAV than the control group (p<0.05). The abdominal aorta systolic and diastolic diameters were similar in the two groups (p>0.05). The children with BAV exhibited significantly lower S (0.210 ± 0.04/0.267 ± 0.07, p<0.001) and DIS (1.04 ± 0.2/1.4 ± 0.4 10(-6) cm(2) dyne(-1), p<0.001); and higher Ep (200 ± 39/153 ± 47 N/m(-2), p<0.001), Ep* (3.42 ± 0.9/2.5 ± 0.9, p<0.001) and βSI (1.1 ± 0.3/0.84 ± 0.3, p<0.001) than the control group. There was no correlation between the systolic and diastolic diameters of abdominal aorta and aortic elasticity parameters (p>0.05).
Conclusion:
Bicuspid aortic valve is associated with an increased abdominal aortic stiffness in children. However, impaired abdominal aortic elasticity is not due to abdominal aortic dilatation. These findings require validation by further studies.
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