Is poststenotic aortic root dilatation dependent on the degree of aortic stenosis?
- 1 I. interní klinika
- 2 Oddělení zdravotnického účtování a statistiky, Fakultní nemocnice Plzeň a Lékařská fakulta Univerzity Karlovy, Plzeň, Česká republika
Aim:
To identify factors, which affect aortic root width in patients with dominant aortic stenosis.
Method:
An analysis of transthoracic and transesophageal echocardiographic examinations performed in our laboratory within a year. A total of 217 patients with dominant aortic stenosis and a maximum gradient ł 25 mm Hg were included, of these 30 with bicuspid and 187 with tricuspid aortic valves were examined. Not eligible for analysis were patients with more than moderate aortic regurgitation.
Results:
The aortic root diameter in patients was greater in the bicuspid valve was significantly greater compared with the tricuspid valve (38.3 ± 5.4 mm vs. 34.9 ± 4.8 mm; p < 0.01). The groups did not differ in height, body surface area, degree of aortic regurgitation, and left ventricular ejection fraction. Patients with a bicuspid valve were younger (57.25 ± 11.68 years vs. 70.62 ± 10.33 years; p < 0.001) and showed a higher maximum pressure gradient (69 ± 26 mm Hg vs. 58 ± 24 mm Hg; p < 0.05). The aortic root diameter was greater bicuspid valves even after indexation by body surface area (20.1 ± 3.6 mm/m2 vs. 18.5 ± 2.6 mm/m2; p < 0.05) and height (22.5 ± 3.5 mm/m vs. 20.7 ± 2.5 mm/m; p < 0.01) and after adjustment to age and maximum gradient in multivariant analysis.
In the entire group of 217 aortic stenoses, the aortic root diameter correlated with the degree of aortic regurgitation (p < 0.001), number of cusps (p < 0.01) and height (p < 0.05).
Conclusion:
The aortic root width correlates with the degree of aortic regurgitation, presence of bicuspid aortic valve and anthropometric parameters irrespective of the degree of stenosis. Congenital aortic wall abnormalities may contribute to poststenotic dilatation of the aorta in patients with bicuspid aortic valve.
Keywords: Aortic stenosis; Bicuspid aortic valve; Aortic root dilatation
Published: May 1, 2005 Show citation