Ekici Filiz, Uslu Diyar, Bozkurt Selen
Department of Pediatric Cardiology, Akdeniz University Faculty of Medicine, Antalya, Turkey.
Department of Biostatistics and Medical Informatics, Akdeniz University Faculty of Medicine, Antalya, Turkey.
Echocardiography. 2017 Nov;34(11):1660-1666. doi: 10.1111/echo.13664. Epub 2017 Aug 22.
The aim of the study was to determine the aortic elasticity parameters (EPs) and myocardial function in children with bicuspid aortic valve (BAV). Additionally, we evaluated the effect of aortic leaflet phenotype (ALP) and aortic dilatation on elasticity parameters.
Sixty-two children diagnosed with isolated BAV (mean age 9.3 years old; patient group) and 63 healthy children (control group) have been evaluated for this study. Patient group was divided into three age subgroups: between 0-6, 7-11 and 12-17 age intervals. Distensibility (DI) and stiffness index (SI) of ascending aorta were calculated by M-mode echocardiographic data. The myocardial functions were evaluated by tissue Doppler echocardiography.
Patient group exhibited significantly lower DI and higher SI than control group (SI: 3.8 ± 1.7 vs 2.4 ± 0.8, P < .0001). The aortic elasticity indexes in patient group with different age subgroups were different from those in control subgroups. Patient group had significantly lower E' velocity at mitral lateral annulus and septum than control group (P < .017 and P < .001). There was no statistically significant correlation between E' velocities and DI/SI values. We, however, found a weak correlation between septal E' velocities and strain values (r = .255, P = .046). EP did not show statistically significant difference with regard to ALP and presence of aortic dilatation.
Abnormality of aortic elasticity and myocardial functions can be detected in children with BAV from infantile to adolescent. Myocardial functions are not related to SI and DI. We considered the possibility of intrinsic aortic wall abnormality in children with BAV.
本研究旨在确定二叶式主动脉瓣（BAV）患儿的主动脉弹性参数（EP）和心肌功能。此外，我们评估了主动脉瓣叶表型（ALP）和主动脉扩张对弹性参数的影响。
本研究评估了62例诊断为孤立性BAV的儿童（平均年龄9.3岁；患者组）和63例健康儿童（对照组）。患者组分为三个年龄亚组：0至6岁、7至11岁和12至17岁年龄段。通过M型超声心动图数据计算升主动脉的扩张性（DI）和僵硬度指数（SI）。通过组织多普勒超声心动图评估心肌功能。
患者组的DI显著低于对照组，SI显著高于对照组（SI：3.8±1.7 vs 2.4±0.8，P<.0001）。不同年龄亚组的患者组主动脉弹性指数与对照亚组不同。患者组二尖瓣外侧瓣环和室间隔处的E'速度显著低于对照组（P<.017和P<.001）。E'速度与DI/SI值之间无统计学显著相关性。然而，我们发现室间隔E'速度与应变值之间存在弱相关性（r=.255，P=.046）。EP在ALP和主动脉扩张方面未显示出统计学显著差异。
从婴儿期到青少年期的BAV患儿可检测到主动脉弹性和心肌功能异常。心肌功能与SI和DI无关。我们考虑了BAV患儿主动脉壁内在异常的可能性。
