title: Dilatation of the ascending aorta and serum alpha 1-antitrypsin level in patients with bicuspid aortic valve.
abstract: Predictors of aortic dilatation are not well described in patients with bicuspid aortic valves (BAV). This study sought to examine the relationship between proximal aortic dilatation and matrix metalloproteinase-9 (MMP-9) and alpha 1-antitrypsin (α1AT) levels in patients with BAV. All patients underwent echocardiography using a standard protocol, and aortic measurements were taken in end-diastole. We studied 82 patients with BAV and categorized them into two groups according to aortic dimensions corrected for body surface area and age. The plasma level of α1AT was routinely determined using a BN ProSpec analyzer (Siemens Healthcare Diagnostics, Marburg, Germany), and that of MMP-9 were determined by ELISA (RayBiotech Inc. Norcross, GA, USA). Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS; SPSS Inc., Chicago, IL, USA) software for Windows version 12. This study included patients with BAV with no or mild valvular impairment. There were no significant differences between groups in terms of gender, body surface area, associated hypertension, diabetes mellitus, hyperlipidemia, or smoking. The mean ascending aortic diameter was 4.38 ± 0.5 mm in group 1 and 3.34 ± 0.35 mm in group 2 (p < 0.001). Plasma concentration of α1AT in patients with ascending aortic dilatation was significantly lower than that in the non-dilated group (1.32 ± 0.27 and 1.49 ± 0.25 g/l, respectively; p = 0.005). However, no significant difference was found in the MMP-9 level between the two groups (336.49 ± 233.11 and 336.39 ± 268.072 pg/ml, respectively; p = 0.96). We observed a significantly negative correlation between ascending aortic diameter and α1AT level (r = -0.300, p = 0.006) and a positive correlation between ascending aortic diameter and age (r = 0.413, p < 0.001). No significant correlation was found between plasma MMP-9 concentration and ascending aortic diameter (r = -0.008, p = 0.94). A multiple linear regression analysis was performed, including age, α1AT level, MMP-9 level, and left ventricular diastolic diameter. In this analysis, α1AT level and age were the independent predictors of aortic dilatation (p = 0.03 and p = 0.02, respectively).
authors.affiliation: Department of Cardiology, Istanbul University Institute of Cardiology, Haseki, Aksaray, 34350 Istanbul, Turkey. kadriye11@yahoo.com
authors.forename: Kadriye Orta
authors.initials: KO
authors.lastname: Kilickesmez
authors.forename: Okay
authors.initials: O
authors.lastname: Abaci
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Kocas
authors.forename: Ahmet
authors.initials: A
authors.lastname: Yildiz
authors.forename: Aysem
authors.initials: A
authors.lastname: Kaya
authors.forename: Baris
authors.initials: B
authors.lastname: Okcun
authors.forename: Serdar
authors.initials: S
authors.lastname: Kucukoglu
mesh_terms: D000328:Adult; D000367:Age Factors; D001011:Aorta / Q000000981:diagnostic imaging / Q000473:pathology*; D001018:Aortic Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D001021:Aortic Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D004108:Dilatation, Pathologic; D015536:Down-Regulation; D015150:Echocardiography, Doppler; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D016014:Linear Models; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D014421:Turkey; D055815:Young Adult; D000515:alpha 1-Antitrypsin / Q000097:blood*
chemical_list: D015415:Biomarkers; C043392:SERPINA1 protein, human; D000515:alpha 1-Antitrypsin; D020780:Matrix Metalloproteinase 9