title: Aortic stiffness and left ventricular diastolic function in children with well-functioning bicuspid aortic valves.
abstract: OBJECTIVE
  Aortic stiffness and diastolic function are abnormal in adults with bicuspid aortic valves (BAVs). The goal of this study was to determine the relationship between aortic stiffness and left ventricular (LV) diastolic impairment in children with well-functioning BAV and no associated congenital heart disease.
  
  
  RESULTS
  This is a retrospective review of echocardiograms in children with isolated BAV (group BAV; N = 50) and healthy frequency-matched controls (group Control; N = 50). We analysed LV systolic and diastolic function, proximal and distal ascending aortic stiffness index (SI), distensibility, and strain. Age range was 0.2-20 (median 11) years. There was no significant difference in blood pressure, normalized LV size and systolic function between the groups. Several parameters of LV diastolic function were lower in group BAV compared with group Control (e.g. septal E': BAV 12 ± 2.3 cm/s; Control 13.5 ± 1.8 cm/s, P < 0.001). All parameters of proximal and distal ascending aortic elasticity were abnormal in group BAV vs. Control (SI proximal ascending aorta: BAV 4.2 ± 1.6; Control 3.0 ± 0.9, P < 0.001). There was no significant correlation between parameters of aortic elasticity and diastolic function. In a subgroup analysis of children with fusion of the right-non vs. right-left coronary cusps, there was no significant difference for any of the parameters analysed.
  
  
  CONCLUSIONS
  Even children with well-functioning isolated BAV have abnormalities in aortic elasticity and diastolic function when compared with the Control group. However, a relationship between the two could not be established.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Yale School of Medicine, 333 Cedar Street, LLCI 302, New Haven, CT 06510, USA constance.weismann@yale.edu.
authors.forename: Constance G
authors.initials: CG
authors.lastname: Weismann
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Yale School of Medicine, 333 Cedar Street, LLCI 302, New Haven, CT 06510, USA.
authors.forename: Kristin C
authors.initials: KC
authors.lastname: Lombardi
authors.affiliation: Echocardiography Laboratory, Yale New Haven Hospital, New Haven, CT, USA.
authors.forename: Bernhard S
authors.initials: BS
authors.lastname: Grell
authors.affiliation: Yale School of Public Health, New Haven, CT, USA.
authors.forename: Veronika
authors.initials: V
authors.lastname: Northrup
authors.affiliation: Division of Cardiology, Department of Medicine, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Lissa
authors.initials: L
authors.lastname: Sugeng
mesh_terms: D000293:Adolescent; D001021:Aortic Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology; D000082882:Bicuspid Aortic Valve Disease; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D059289:Vascular Stiffness; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D055815:Young Adult
keywords: Aortic stiffness; Bicuspid aortic valve; Left ventricular diastolic function; Tissue Doppler echocardiography; Vascular–ventricular interaction