Share this page on LinkedIn
Share This Page on Google+
Share This Page on Twitter
tell someone about this page print this page
You are here: Contents > 2012 > Volume 21 Number 5 September 2012 > AORTIC VALVE DISEASE > Abnormal Left Ventricular Mechanics in isolated Bicuspid Aortic Valve Disease may be independent of aortic distensibility: 2D Strain Imaging Study

Abnormal Left Ventricular Mechanics in isolated Bicuspid Aortic Valve Disease may be independent of aortic distensibility: 2D Strain Imaging Study

Mustafa Kurt, Ibrahim Halil Tanboga, Emine Bilen, Turgay Isik, Ahmet Kaya, Mehmet Fatih Karakaş, Eyup Büyükkaya

Mutafa Kemal University Medical School, Department of Cardiology, Hatay, Turkey, Erzurum Education and Research Hospital, Department of Cardiology, Erzurum, Turkey, Ataturk Education and Research Hospital, Department of Cardiology, Ankara, Turkey

Background and aim of the study: In this study, we hypothesized that subclinical impairment of left ventricular (LV) mechanical function in bicuspid aortic valve (BAV) patients is independent of valvular hemodynamics represented by valvuloarterial impedance and aortic elastic characteristics. Therefore, we aimed to test left ventricular mechanics in cases of isolated non-stenotic BAV with non-dilated aorta.
Methods: Thirty-three patients with isolated BAV exhibiting non-dilated aorta, and 25 age-and gender-matched healthy subjects were included in the study. Patients with aortic valve velocity > 1.5 m/s and mild-to-moderate aortic regurgitation or ascending aorta diameter >3.5 cm were excluded from the study. Aortic elasticity parameters and valvulo-arterial impedance were calculated. Strain measurements were reported as the peak longitudinal strain (LS) for four chamber (4C), long axis (LAX) and two chamber (2C) views. Strain rate (Sr) measurements were reported as the peak systolic strain rate (Sr-sm), early diastolic strain rate (Sr-em) and late diastolic strain rate (Sr-am) for 4C, LAX and 2C views.

Results: Systolic and diastolic diameters of the ascending aorta, aortic elastic properties (aortic strain, aortic distensibility, aortic stiffness and aortic elastic modulus), and valvulo-arterial impedances were found to be comparable between the BAV and control groups. BAV group was observed to have statistically significantly lower 4C (18.9±1.7 vs 17.8±1.5, p=0.02), LAX (19.7±1.7 vs 17.7±1.3, p=0.001) and 2C (20.1±1.8 vs 17.7±1.2, p<0.001) peak longitudinal strain values compared with the control group. Moreover, LV-GS values were found to be significantly lower in the BAV group than in the control group (19.6±1.1 vs 17.7±0.9, p<0.001). However, there was no statistically significant difference between the groups in terms of Sr-sm, Sr-em ve Sr-am values in the 4C, LAX, and
2C views.
Conclusion: BAV might affect LV systolic functions, assessed by 2D strain imaging, in a fashion independent from the valvular dynamics and aortic elasticity. This might show that BAV is not only a valvular disease, but possibly a ventricular disease as well.

The Journal of Heart Valve Disease 2012;21:608-614

Abnormal Left Ventricular Mechanics in isolated Bicuspid Aortic Valve Disease may be independent of aortic distensibility: 2D Strain Imaging Study

Click the above hyperlink to view the article, right click (Ctrl click on a Mac) to open in a new browser window or tab.

Purchase this Article

Please click the button below to purchase this article. Single article purchases are provided at $50.00 per article. Upon clicking the button below, single article user account subscription details are requested and, upon successful payment, a single article user account is created. Single articles are availble in your account for seven days after purchase.