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Association of Aortic Phenotypes and Mechanical Function With Left Ventricular Diastolic Function in Subjects With Normally Functioning Bicuspid Aortic Valves and Comparison to Subjects With Tricuspid Aortic Valves

 Soo Youn Lee  ;  Chi Young Shim  ;  Geu-Ru Hong  ;  Jiwon Seo  ;  Iksung Cho  ;  In Jeong Cho  ;  Hyuk-Jae Chang  ;  Jong-Won Ha  ;  Namsik Chung 
 American Journal of Cardiology, Vol.116(10) : 1547-1554, 2015 
Journal Title
 American Journal of Cardiology 
Issue Date
Aortic Valve/abnormalities* ; Aortic Valve/diagnostic imaging* ; Aortic Valve/physiopathology ; Diastole ; Echocardiography, Doppler ; Female ; Heart Valve Diseases/diagnosis ; Heart Valve Diseases/physiopathology* ; Humans ; Male ; Middle Aged ; Phenotype ; Tricuspid Valve/diagnostic imaging ; Tricuspid Valve/physiopathology* ; Vascular Stiffness/physiology* ; Ventricular Function, Left/physiology*
A bicuspid aortic valve (BAV) is often associated with dilation or aneurysm of the ascending aorta (AA) despite of absence of significant valve dysfunction. Bicuspid aortopathy and consequent aortic stiffness may adversely affect left ventricular (LV) diastolic function. This study aimed to investigate the impact of global and regional aortic mechanical function on LV diastolic function in subjects with BAV. Fifty-six subjects with BAV (45 men, mean age 52 ± 13 years) without significant valve dysfunction and 56 age- and gender-matched controls with tricuspid aortic valve were studied. The aortic phenotypes were classified into 3 groups: normal shape, predominant dilatation of the sinus of Valsalva, and predominant dilatation of the AA. Structural and functional parameters of the AA and LV were measured using 2-dimensional echocardiography. Global aortic mechanical function was assessed by radial artery tonometry. The subjects with BAV showed a higher incidence of a predominant AA phenotype (53.6% vs 17.9%, p <0.001), larger indexed aortic diameters, increased augmentation index, lower pulse pressure amplification, lower early diastolic mitral annular (e') velocity, and higher E/e' than those with tricuspid aortic valve . The e' velocity and E/e' varied with different aortic phenotypes in subjects with BAV. Correlations between e' velocity and parameters of aortic stiffness were stronger in subjects with BAV than those in controls. Multiple regression analysis revealed that augmentation index normalized for a heart rate of 75 beats/min was an independent determinant of e' velocity (β = -0.24, p = 0.044) and E/e' (β = 0.30, p = 0.018) in subjects with BAV even after controlling for confounding factors. LV diastolic function is closely related to aortic phenotype and mechanical alteration in subjects with BAV.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
서지원(Seo, Jiwon) ORCID logo https://orcid.org/0000-0002-7641-3739
심지영(Shim, Chi Young) ORCID logo https://orcid.org/0000-0002-6136-0136
이수연(Lee, Soo Youn)
장혁재(Chang, Hyuck Jae) ORCID logo https://orcid.org/0000-0002-6139-7545
정남식(Chung, Nam Sik)
조익성(Cho, Ik Sung)
조인정(Cho, In Jeong)
하종원(Ha, Jong Won) ORCID logo https://orcid.org/0000-0002-8260-2958
홍그루(Hong, Geu Ru) ORCID logo https://orcid.org/0000-0003-4981-3304
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