Bicuspid aortic valve (BAV) is a common congenital malformation with the known sequela
of ascending aortic dilation. The morphology of the BAV and the elasticity of the
adjacent ascending aorta appear to influence the outcome. We prospectively examined
48 pediatric patients with an isolated, native BAV for the morphology and size of
the aortic valve, aortic root, sinotubular junction, and ascending aorta and their
elasticity indexes. A cohort of 48 matching subjects with tricuspid aortic valves
was investigated as controls. A comparison of the aortic valve subtypes showed normal-size
aortic dimensions in the tricuspid aortic valves. In contrast, in the BAVs, the ascending
aorta and aortic valve itself tended to dilate with age and aortic elasticity deteriorated.
In the BAVs, the stiffness was significantly greater (4.43 ± 1.82 vs 3.43 ± 0.81 in
the tricuspid aortic valves; p = 0.001). The distensibility indexes decreased inversely
in the BAVs (6.57 ± 2.83 vs 7.84 ± 2.04 cm2 × dynes−1 × 10−6, p = 0.013; and 53.5 ± 26.0 versus 64.3 ± 17.9 kPa−1 × 10−3, p = 0.020). The anteroposterior-oriented phenotype of BAVs showed significantly
stiffer and less distensible elasticity even after correction for congenital valve
dysfunction, which was more frequent in the left–right-oriented phenotype. In conclusion,
the morphology of the BAV seems to play a major role in the outcome of BAV disease,
although the left–right phenotype is more prone to congenital valve dysfunction, the
anteroposterior phenotype showed worse elasticity quality.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Clinical significance of the bicuspid aortic valve.Heart. 2000; 83: 81-85
- Usefulness of bicuspid aortic valve phenotype to predict elastic properties of the ascending aorta.Am J Cardiol. 2007; 99: 686-690
- Aortic elasticity and size in bicuspid aortic valve syndrome.Eur Heart J. 2008; 29: 472-479
- Abnormal aortic elastic properties in adults with congenital valvular aortic stenosis.Int J Cardiol. 2008; 128: 336-341
- Reduced aortic elasticity and dilatation are associated with aortic regurgitation and left ventricular hypertrophy in nonstenotic bicuspid aortic valve patients.J Am Coll Cardiol. 2007; 49: 1660-1665
- Two-dimensional echocardiographic aortic root dimensions in normal children and adults.Am J Cardiol. 1989; 64: 507-512
- Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography.J Am Soc Echocardiogr. 2003; 16: 777-802
- Dilatation of the ascending aorta in paediatric patients with bicuspid aortic valve: frequency, rate of progression and risk factors.Heart. 2006; 92: 1496-1500
- Outcome of isolated bicuspid aortic valve in childhood.J Pediatr. 2010; 157: 445-449
- Morphology of bicuspid aortic valve in children and adolescents.J Am Coll Cardiol. 2004; 44: 1648-1651
- Progressive dilation of the ascending aorta in children with isolated bicuspid aortic valve.Am J Cardiol. 2007; 99: 978-983
- Progression of aortic dilation in children with a functionally normal bicuspid aortic valve.Am J Cardiol. 2006; 98: 828-830
- Frequency of aortic root dilation in children with a bicuspid aortic valve.Am J Cardiol. 2004; 94: 1337-1340
- Outcomes in adults with bicuspid aortic valves.JAMA. 2008; 300: 1317-1325
- Different patterns of aortic wall elasticity in patients with Marfan syndrome: a noninvasive follow-up study.J Thorac Cardiovasc Surg. 2006; 132: 811-819
- Aortic biomechanical properties in pediatric patients with the Marfan syndrome, and the effects of Atenolol.Am J Cardiol. 1993; 71: 606-608
Article Info
Publication History
Published online: July 23, 2012
Accepted:
June 13,
2012
Received in revised form:
June 13,
2012
Received:
April 7,
2012
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
