Eskisehir Osmangazi University, Faculty of Medicine, Department of Pediatric Cardiology, Eskisehir - Turquia.
Eskisehir State Hospital, Pediatric Cardiology Clinic, Eskisehir - Turquia.
Arq Bras Cardiol. 2021 Dec;117(6):1126-1133. doi: 10.36660/abc.20200657.
Arterial stiffness is an important predictor factor of aortopathy and myocardial remodeling in patients with a bicuspid aortic valve and it might be increased in childhood.
To assess the arterial stiffness and left ventricular myocardial function in children with a well-functioning bicuspid aortic valve.
Forty-four children with a bicuspid aortic valve and 41 healthy peers with a tricuspid aortic valve were included in this case-control study. Diameters and the related z-scores of the aortic root and ascending aorta were obtained. As for the left ventricular myocardial function, along with the mitral inflow velocities and M-Mode parameters, myocardial velocities and time intervals were assessed with tissue Doppler imaging. A pulse wave analysis was performed by oscillometric device (Mobil-o-Graph). A p value <0.05 was considered significant.
The left ventricular mass index, mitral inflow A velocity, diameter and z-score of the ascending aorta, and myocardial performance index were significantly higher in patients (p=0.04, p=0.02,p=0.04, p<0.001,and p<0.001 respectively). The myocardial performance index was positively correlated with the diameter of the ascending aorta and A velocity (r=0.272;p=0.01, r=356;p=0.001, respectively). The multivariate analysis revealed that the myocardial performance index was related to the ascending aorta diameter (p=0.01). The augmentation index and pulse wave velocity were similar between the groups (p>0.05).
According to the oscillometric pulse wave analysis, the children with a well-functioning bicuspid aortic valve had similar arterial stiffness to that of the healthy peers. The ascending aorta diameter was established as an independent predictor of left ventricular myocardial function. Arterial stiffness may not be a severe risk factor in pediatric patients without marked ascending aorta dilation.
在患有二叶式主动脉瓣的患者中，动脉僵硬度是主动脉瓣病变和心肌重构的重要预测因素，并且其可能在儿童期增加。
评估功能正常的二叶式主动脉瓣患儿的动脉僵硬度和左心室心肌功能。
本病例对照研究纳入了 44 例患有二叶式主动脉瓣的儿童和 41 名健康的三叶式主动脉瓣同龄者。获得了主动脉根部和升主动脉的直径及其相关 z 评分。对于左心室心肌功能，除了二尖瓣流入速度和 M 型参数外，还使用组织多普勒成像评估心肌速度和时间间隔。通过振荡测量设备（Mobil-o-Graph）进行脉搏波分析。p 值<0.05 被认为有统计学意义。
患儿的左心室质量指数、二尖瓣流入 A 速度、升主动脉直径和 z 评分以及心肌做功指数均显著升高（p=0.04、p=0.02、p=0.04、p<0.001 和 p<0.001）。心肌做功指数与升主动脉直径和 A 速度呈正相关（r=0.272；p=0.01，r=3.56；p=0.001）。多变量分析显示，心肌做功指数与升主动脉直径有关（p=0.01）。两组的增强指数和脉搏波速度相似（p>0.05）。
根据振荡式脉搏波分析，功能正常的二叶式主动脉瓣患儿的动脉僵硬度与健康同龄人相似。升主动脉直径是左心室心肌功能的独立预测因子。在没有明显升主动脉扩张的儿科患者中，动脉僵硬度可能不是严重的危险因素。
