P26 Ascending Aorta Longitudinal Strain is not Altered in Bicuspid Aortic Valve Patients

Abstract

Background

Impaired ascending aorta (AAo) longitudinal strain, a marker of AAo deformation due to aorto-ventricular mechanical interaction, is related to progressive dilation and aortic events in Marfan syndrome [1]. Whether the high prevalence of dilation in bicuspid aortic valve (BAV) is due to intrinsically-altered aortic wall properties [2] or hemodynamic [3] is widely-discussed [4]. Whether AAo longitudinal strain is altered in BAV patients has never been assessed.

Methods

One-hundred five BAV patients, 47 patients with AAo dilation and tricuspid aortic valve (TAV) and 31 healthy volunteers, free from previous cardiac/aortic surgery, dissection and moderate/severe valvular disease had cine MR images to compute AAo longitudinal strain [1].

Results

Compared to healthy volunteers, the 25 non-dilated (z-score < 2) BAV patients were older (p < 0.001), had higher systolic blood pressure (SBP, p = 0.001), clinically-meaningless (BAV z-score = 0.74 ± 1.1) larger AAo diameter (p < 0.001) and similar diastolic blood pressure (DBP), BSA, stroke volume and heart rate. AAo longitudinal strain was lower in non-dilated BAV compared to healthy volunteers (13.7 vs 10.3%, p = 0.008) but this difference was not significant after correction for age. Compared to dilated TAV, dilated BAV patients were younger (p < 0.001), had lower BSA (p = 0.010) and AAo diameter (p = 0.003), higher DBP (p = 0.032) and similar SBP, stroke volume and heart rate. AAo longitudinal strain was higher in dilated BAV compared to dilated TAV (10 vs 7.2%, p < 0.001) but this difference was not significant after correction for age, BSA and DBP.

Conclusion

AAo longitudinal strain is similar in BAV and TAV matched for aortic dilation.