Şimşek Ersin Çagrı, Yakar Tülüce Selcen, Tülüce Kamil, Emren Sadık Volkan, Çuhadar Serap, Nazlı Cem
Department of Cardiology, University of Health Science, Tepecik Training and Research Hospital, Izmir, Turkey.
Department of Cardiology, Katip Çelebi University Atatürk Training and Research Hospital, Izmir, Turkey.
Congenit Heart Dis. 2019 Mar;14(2):256-263. doi: 10.1111/chd.12718. Epub 2018 Nov 28.
The bicuspid aortic valve (BAV) is the most common congenital heart disease. The process of aortic dilatation is not completely clear in patients with the BAV. Apelin is a peptide found at high levels in vascular endothelial cells which has a role in vascular regulation and cardiovascular function. The aim of this study was to determine the relationship between serum apelin levels and ascending aortic dilatation in adult patients with BAV.
This cross-sectional study included 62 patients with isolated BAV and to an age, gender, and body mass index-matched control group of 58 healthy volunteers with tricuspid aortic valve. Transesophageal echocardiography was performed on all patients to determine the type of BAV. Aortic diameters of the aortic root, sinus valsalva, sinotubular junction, and ascending aorta were evaluated with echocardiography. Patients with BAV were divided into two subgroups according to the aortic diameters, as the nondilated BAV group and the dilated BAV group. Serum apelin level was analyzed with ELISA method.
The serum apelin levels of the BAV patients were significantly lower than those of the control group (833.5, 25th-75th percentile (713.5-1745) pg/dL vs 1669 (936-2543) pg/dL; P = 0.006). In the subgroup analysis, serum apelin level was significantly different between the nondilated BAV group and the dilated BAV group [977 (790-2433) pg/dL vs 737 (693-870) pg/dL, P < 0.05] and between the dilated BAV group and the control group [737 (693-870) pg/dL vs 1669 (936-2543) pg/dL, P < 0.001]. In multivariate logistic regression analysis apelin [7.27 (95% CI: 1.73-30.42), P = 0.007] and age [1.05 (95% CI: 0.99-1.20), P = 0.049] were determined as independent predictors for ascending aortic dilatation.
Low serum apelin level was associated with dilatation of ascending aortic in BAV patients. However, apelin was not relevant to BAV without aortic dilatation.
二叶式主动脉瓣（BAV）是最常见的先天性心脏病。BAV患者主动脉扩张的过程尚不完全清楚。Apelin是一种在血管内皮细胞中高表达的肽，在血管调节和心血管功能中发挥作用。本研究旨在确定成年BAV患者血清Apelin水平与升主动脉扩张之间的关系。
这项横断面研究纳入了62例孤立性BAV患者，并与58例年龄、性别和体重指数匹配的三尖瓣主动脉瓣健康志愿者组成的对照组进行比较。对所有患者进行经食管超声心动图检查以确定BAV的类型。通过超声心动图评估主动脉根部、主动脉窦、窦管交界和升主动脉的直径。根据主动脉直径将BAV患者分为两个亚组，即未扩张BAV组和扩张BAV组。采用酶联免疫吸附测定（ELISA）法分析血清Apelin水平。
BAV患者的血清Apelin水平显著低于对照组（第25至75百分位数为833.5（713.5 - 1745）pg/dL，而对照组为1669（936 - 2543）pg/dL；P = 0.006）。在亚组分析中，未扩张BAV组与扩张BAV组之间血清Apelin水平存在显著差异[977（790 - 2433）pg/dL对737（693 - 870）pg/dL，P < 0.05]，扩张BAV组与对照组之间也存在显著差异[737（693 - 870）pg/dL对1669（936 - 2543）pg/dL，P < 0.001]。在多因素逻辑回归分析中，Apelin[7.27（95%置信区间：1.73 - 30.42），P = 0.007]和年龄[1.05（95%置信区间：0.99 - 1.20），P = 0.049]被确定为升主动脉扩张的独立预测因素。
BAV患者血清Apelin水平低与升主动脉扩张有关。然而，Apelin与无主动脉扩张的BAV无关。
