title: Evaluation of left atrial mechanical function and atrial conduction abnormalities in patients with isolated bicuspid aortic valve.
abstract: OBJECTIVE
  Present study is an evaluation of left atrial (LA) mechanical and conduction function in patients with bicuspid aortic valve (BAV) without significant valve dysfunction, and an investigation of relationship between LA function and aortic elasticity.
  
  
  METHODS
  Study population consisted of 34 isolated BAV patients (mean age: 34±13 years) and 29 healthy, age- and sex-matched volunteers (mean age: 30±10 years). LA volume was measured using biplane area-length method and LA active and passive emptying volume and fraction was calculated. Intra- and interatrial atrial conduction time (ACT) was measured with tissue Doppler imaging. Aortic elasticity parameters were calculated including aortic strain, aortic stiffness index, aortic distensibility, and aortic elastic modulus.
  
  
  RESULTS
  LA diameter, LA maximum volume, LA volume before atrial systole, and LA active emptying fraction were significantly higher in patients with BAV (33.2±3.2 mm vs 34.9±2.8 mm, p=0.030; 16.2±4.6 mL/m2 vs 19.8±4.8 mL/m2, p=0.004; 10.2±3.7 mL/m2 vs 12.1±4.9 mL/m2, p=0.029; and 30.4±12.0% vs 39.9±11.8%, p=0.003, respectively). ACT was similar between groups. Aortic distensibility was significantly lower and aortic stiffness index and aortic elastic modulus were significantly higher in patients with BAV (8.1±4.6 [10-6cm2dyn-1] vs 5.1±3.6 [10-6cm2dyn-1], p=0.006; 4.1±2.8 vs 7.3±4.9, p=0.003; 3.6±2.8 [dyn.cm-2106] vs 5.9±3.9 [dyn.cm-2106], p=0.010, respectively). In correlation analysis, LA active emptying fraction was significantly correlated with aortic stiffness index and mitral A- velocity (r=0.431, p<0.001; r=0.304, p=0.016, respectively).
  
  
  CONCLUSIONS
  The present study demonstrated that LA mechanical functions and aortic elasticity parameters were deteriorated, while atrial conduction time was preserved in patients with isolated BAV. Furthermore, LA mechanical functions were significantly correlated with aortic elasticity parameters and mitral inflow A-wave velocity.
authors.affiliation: Department of Cardiology, Gaziosmapaşa University Faculty of Medicine, Tokat, Turkey. arfarsy@hotmail.com.
authors.forename: Arif
authors.initials: A
authors.lastname: Arısoy
authors.forename: Kadriye
authors.initials: K
authors.lastname: Memiç
authors.forename: Selami
authors.initials: S
authors.lastname: Demirelli
authors.forename: Kayıhan
authors.initials: K
authors.lastname: Karaman
authors.forename: Fatih
authors.initials: F
authors.lastname: Altunkaş
authors.forename: Metin
authors.initials: M
authors.lastname: Karayakalı
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Karavelioğlu
authors.forename: Ataç
authors.initials: A
authors.lastname: Çelik
mesh_terms: D000328:Adult; D001011:Aorta / Q000503:physiopathology*; D001021:Aortic Valve / Q000002:abnormalities* / Q000503:physiopathology; D000082882:Bicuspid Aortic Valve Disease; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006329:Heart Conduction System; D006349:Heart Valve Diseases / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D059289:Vascular Stiffness; D055815:Young Adult