The Relationship between Arterial Elasticity Parameters of Ascending Aorta, Abdominal Aorta and Carotid Arteries with Carotid Intima Media Thickness in Children with Bicuspid Aortic Valve

Abstract

Background: Bicuspid aortic valve is a congenital cardiac malformation that affects not \ronly the valve and ascending aorta but also the abdominal aorta and large central arteries like carotid arteries by damaging the elasticity of the vessel resulting in increased \rstiffness and reduced distensibility. Deterioration of aortic compliance disturbs functions \rof the left ventricle and triggers atherosclerosis determined with carotid intima-media \rthickness. The aim of this study was to assess the effect of the bicuspid aortic valve on \rthe elastic properties of these parts of the arterial system in children.\rMethods: Thirty-four children with bicuspid aortic valves with normal valvular functions \ror mild valvular dysfunction and a control group of 34 individuals with tricuspid aortic \rvalves were included in the study. Echocardiographic measurements of the left ventricle, ascending aorta, and ultrasonographic measurements of the abdominal aorta and \rcarotid arteries were performed, and elasticity indexes were calculated.\rResults: The bicuspid aortic valve group had higher stiffness and lower distensibility \rin ascending aorta, abdominal aorta, and carotid arteries with higher carotid intimamedia thickness values than the tricuspid aortic valve group. Aortic valvular z scores \rand ascending aorta and abdominal aorta stiffness were higher in patients with bicuspid aortic valves irrespective of valvular functions than in controls. Valvular dysfunction \raffected stiffness in carotid arteries. Dilatation of ascending aorta increased stiffness in \rthe abdominal aorta. Distensibility was lower in ascending aorta and left carotid artery, \rwith increased carotid intima-media thickness independent from ascending aorta dilatation. Stiffness of abdominal aorta revealed a positive correlation with the stiffness of \rthe ascending aorta and the carotid arteries (P < .05, for all).\rConclusions: Elasticity indexes of children with bicuspid aortic valves were impaired \rin ascending aorta, abdominal aorta, and carotid arteries with an increase in carotid \rintima-media thickness.