Abaci Okay, Kocas Cuneyt, Kilickesmez Kadriye Orta, Uner Sinan, Kucukoglu Serdar
Department of Cardiology, Cardiology Institute of Istanbul University, Istanbul, Turkey.
Echocardiography. 2013 Feb;30(2):121-6. doi: 10.1111/echo.12004. Epub 2012 Oct 24.
Predictors of aortic dilatation are not well-described in patients with bicuspid aortic valve (BAV). Changes in extracellular matrix composition in the aortic wall may play an important role. Our study aimed to examine the relationship between ascending aortic dilatation and biochemical markers for collagen metabolism, such as matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) levels in patients with BAV.
All patients underwent cardiac echocardiography using a standard protocol, and aortic measurements were made in end-diastole. One hundred twelve BAV patients with no or mild valvular impairment were recruited and grouped according to the aortic dimensions corrected for body surface area (BSA) and age. There were 54 patients with dilated ascending aorta (Group 1) and 58 patients with nondilated ascending aorta (group 2). The plasma levels of MMP-2 and MMP-9 were determined by ELISA.
The mean ascending aorta diameter was 4.49 ± 0.49 mm in group 1 and 3.51 ± 0.46 mm in group 2 (P < 0.001). There were no significant difference in gender, BSA, presence of hypertension, diabetes mellitus, hyperlipidemia, and smoking between the 2 groups. Nevertheless, no significant difference was observed in the levels of MMP-2 and MMP-9 between the 2 groups. The ascending aorta diameter correlated significantly with age (r = 0.438 P < 0.001). No significant correlation was observed between plasma MMP-2 and MMP-9 concentration and ascending aorta diameter, respectively (r = -0.005 P = 0.58, r = -0.106 P = 0.07). Multivariate analysis showed that age was independent predictor of aortic dilatation (P ≤ 0.001).
Age was an independent predictor of aortic dilatation in patients with BAV, whereas MMP-2 and 9 levels were not relevant by aortic dilatation.
在二叶式主动脉瓣（BAV）患者中，主动脉扩张的预测因素尚未得到充分描述。主动脉壁细胞外基质成分的变化可能起重要作用。我们的研究旨在探讨BAV患者升主动脉扩张与胶原蛋白代谢生化标志物之间的关系，如基质金属蛋白酶-2（MMP-2）和基质金属蛋白酶-9（MMP-9）水平。
所有患者均按照标准方案进行心脏超声心动图检查，并在舒张末期进行主动脉测量。招募了112例无或轻度瓣膜损害的BAV患者，并根据校正体表面积（BSA）和年龄后的主动脉尺寸进行分组。有54例升主动脉扩张患者（第1组）和58例升主动脉未扩张患者（第2组）。通过酶联免疫吸附测定法（ELISA）测定血浆MMP-2和MMP-9水平。
第1组升主动脉平均直径为4.49±0.49mm，第2组为3.51±0.46mm（P<0.001）。两组之间在性别、BSA、高血压、糖尿病、高脂血症和吸烟情况方面无显著差异。然而，两组之间MMP-2和MMP-9水平无显著差异。升主动脉直径与年龄显著相关（r=0.438，P<0.001）。血浆MMP-2和MMP-9浓度与升主动脉直径之间分别未观察到显著相关性（r=-0.005，P=0.58；r=-0.106，P=0.07）。多变量分析显示年龄是主动脉扩张的独立预测因素（P≤0.001）。
年龄是BAV患者主动脉扩张的独立预测因素，而MMP-2和9水平与主动脉扩张无关。
