Central pulse pressure and augmentation index in asymptomatic bicuspid aortic valve disease

Aydin, Ali; Mortensen, Kai; Rybczynski, Meike; Sheikhzadeh, Sara; Willmann, Svenia; Bernhardt, A.; Hillebrand, Mathias; Stritzke, Jan; Baulmann, Johannes; Schunkert, Heribert; Keil, Ulrich; Hense, Hans Werner; Meisinger, Christa; Robinson, Peter N.; Berger, Jürgen; Willems, Stephan; Meinertz, Thomas; Kodolitsch, Yskert Von

doi:10.1016/j.ijcard.2011.01.018

Cited by 12 publications

(5 citation statements)

References 5 publications

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“…It is interesting to note that valve replacement and normalization of aberrant central flow profiles in BAV does not mitigate aortic dilation progression [11]. Abnormalities in AIx reported herein, and elsewhere [22,23], may reflect a previously unsuspected role for increased pressure from wave reflections in the development of large vessel arteriopathy in patients with BAV. In other patient populations such as Marfan syndrome, increased AIx has been shown to predict progression of aortic disease [36,37].…”

Section: Discussionmentioning

confidence: 75%

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Augmentation index and aortic stiffness in bicuspid aortic valve patients with non-dilated proximal aortas

Warner

Al-Quthami

Brooks

et al. 2013

BMC Cardiovasc Disord

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BackgroundWe compared aortic stiffness, aortic impedance and pressure from wave reflections in the setting of bicuspid aortic valve (BAV) to the tricuspid aortic valve (TAV) in the absence of proximal aortic dilation. We hypothesized BAV is associated with abnormal arterial stiffness.MethodsTen BAV subjects (47 ± 4 years, 6 male) and 13 TAV subjects (46 ± 4 years, 10 male) without significant aortic valve disease were prospectively recruited. Characteristic impedance (Zc) was derived from echocardiographic images and pulse wave Doppler of the left ventricular outflow tract. Applanation tonometry was performed to obtain pulse wave velocity (PWV) at several sites as measures of arterial stiffness and augmentation index (AIx) as a measure of wave reflection.ResultsThere were no significant differences between BAV and TAV subjects with regard to heart rate or blood pressure. Zc was similar between BAV and TAV subjects (p=0.25) as was carotid-femoral pulse wave velocity (cf-PWV) and carotid-radial PWV (cr-PWV) between BAV and TAV subjects (p=0.99). Carotid AIx was significantly higher in BAV patients compared with TAV patients (14.3 ± 4.18% versus -3.02 ± 3.96%, p=0.007).ConclusionsAortic stiffness and impedance is similar between subjects with BAV and TAV with normal aortic dimensions. The significantly higher carotid AIx in BAV, a proxy of increased pressure from wave reflections, may reflect abnormal vascular function distal to the aorta.

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Section: Discussionmentioning

confidence: 75%

“…Previous studies noting increased AIx in BAV were carried out in patients with aortic dilation [22,23]. This is important as patients with BAV and dilated aortas have increased aortic PWV compared to BAV patients with preserved aortic size [24].…”

Section: Discussionmentioning

confidence: 99%

Augmentation index and aortic stiffness in bicuspid aortic valve patients with non-dilated proximal aortas

Warner

Al-Quthami

Brooks

et al. 2013

BMC Cardiovasc Disord

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“…This variation in-between and within studies itself complicates the comparison of echocardiographic parameters, that should be discussed regarding age and pubertal status, respectively. Additionally, sex, ethnicity, and genetic influences contribute to the variability in results [ 4 , 29 , 31 , 37 , 57 , 58 ]. Regarding sex, females are not represented equally in the literature.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Structure and Function in Junior Athletes: A Systematic Review of Echocardiographic Studies

Weberruß¹,

Engl²,

Baumgartner³

et al. 2022

Rev. Cardiovasc. Med.

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Background: In young athletes, the level of competitiveness in sports is increasing, as well as frequency and intensity of exercise training. Adaptations of the cardiac system to this increased workload imposed by exercise has not yet been studied sufficiently. In adults, studies point towards a shift from the functional athlete's heart towards pathological cardiac remodelling, with ventricular arrythmia and impaired cardiac function, that is exercise-related. This systematic review investigates cardiac adaptations to exercise in junior athletes compared to inactive controls. Methods: Three electronic databases (PubMed/Medline, ScienceDirect and Web of Science) were searched for studies assessing 2-dimensional transthoracic echocardiography (2D TTE) and 2-dimensional speckle tracking echocardiography (2D STE) parameters in junior athletes, aged 7-19 years, compared to inactive controls. Data was screened and extracted by two reviewers; study quality and risk of bias was assessed by three reviewers. Results: Eight out of 1460 studies met all inclusion criteria, with all studies reporting results on 2D TTE and six studies reporting results on 2D STE parameters in 540 (51 girls) junior athletes and 270 (18 girls) controls. There is evidence for structural cardiac adaptations of the left ventricle and both atria in junior athletes. Results regarding left ventricular function are controversial with a tendency to improved function in dynamic exercising athletes. Left ventricular mass and relative wall thickness point towards higher values in static exercising athletes. Conclusions: Cardiac adaptations to exercise occur in children and adolescents. These adaptations are more pronounced in structural left ventricular parameters. Functional parameters are preserved or slightly improved in junior athletes but not impaired by exercise.

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“…[72] The aortic roots have variable amounts of elastin and larger baseline aortic root diameters than the general population. [73][74][75] The underlying genetic association has yet to be determined.…”

Section: Ascending Aorta and Root Aneurysmsmentioning

confidence: 99%

Surgical Management of the Aortic Root

Goslin¹,

Hooker²

2012

Current Concepts in General Thoracic Surgery

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Central pulse pressure and augmentation index in asymptomatic bicuspid aortic valve disease

Cited by 12 publications

References 5 publications

Augmentation index and aortic stiffness in bicuspid aortic valve patients with non-dilated proximal aortas

Augmentation index and aortic stiffness in bicuspid aortic valve patients with non-dilated proximal aortas

Cardiac Structure and Function in Junior Athletes: A Systematic Review of Echocardiographic Studies

Surgical Management of the Aortic Root

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