Myocardial hypertrophy and intracardial hemodynamics in children with bicuspid aortic valve

Authors

  • А. V. Kamenshchyk Zaporizhzhia State Medical University, Ukraine,
  • O. G. Ivanko Zaporizhzhia State Medical University, Ukraine,

DOI:

https://doi.org/10.14739/2310-1237.2017.2.109296

Keywords:

bicuspid aortic valve, children, heart hypertrophy, dopplerechocardiography, hemodynamics, regression analysis

Abstract

Bicuspid aortic valve is one of the most common congenital heart diseases with low manifestation in childhood and severe consequences in adults that determines the importance in early diagnostics of myocardial changes in this anomaly. According to the literature the polymorphisms in the genes of NFATC family could result both in impaired embriogenetic valves formation and development of postnatal myocardial hypertrophy.

The aim of the study was to detect the early changes of intracardial hemodynamics at aortic valve in children with bicuspid aortic valve (BAV) and establish their interrelations to the signs of myocardial hypertrophy in these children.

Materials and methods: Dopplerograhphic study of basic intracardiac hemodynamics parameters in 38 children with BAV and in 28 children of control group was conducted. The results were processed statistically by Student’s t-test, correlation analysis and multiple regression.

Results: In the result of study the moderate concentric left ventricle myocardial hypertrophy development was detected in 62 % of children with BAV which is accompanying to significant increasing of blood flow velocity and pressure gradient at aortic valve. There were not established significant correlations between the parameters of hemodynamics at valve and left ventricle’s posterior wall depth and septum depth whereas the highest inputs of these values were obtained in the left ventricle systolic dimension and volume and less in the hypertrophic signs.

Conclusions: In children with BAV the moderate concentric myocardial hypertrophy with significant changes of intracardial hemodynamics at aortic valve takes place with the highest inputs in left ventricle volumetric values  The obtained data serves as a substantiation for the treatment and prevention of it further development.

References

Hales, A. R., & Mahle, W. T. (2014) Echocardiography screening of siblings of children with bicuspid aortic valve. Pediatrics, 133, e1212. doi: 10.1542/peds.2013-3051.

Petit, C. J., Gao, K., Goldstein, B. H., Lang, S. M., Gillespie, S. E., Kim, S. I., & Sachdeva, R. (2016) Relation of Aortic Valve Morphologic Characteristics to Aortic Valve Insufficiency and Residual Stenosis in Children With Congenital Aortic Stenosis Undergoing Balloon Valvuloplasty. Am J Cardiol., 117(6), 972. doi: 10.1016/j.amjcard.2015.12.034.

Siu, S. C., & Candice, K. (2010) Bicuspid aortic valve disease. Journal of the American College of Cardiology, 55(25), 2789–2800. doi: 10.1016/j.jacc.2009.12.068.

Hanedan Onan, S., Baykan, A., Sezer, S., Narin, F., Mavili, E., Baykan, Z., et al. (2016) Evaluation of cardiovascular changes in children with BAVS. Pediatr Cardiol., 37(3), 472–481. doi: 10.1007/s00246-015-1302-6.

Calloway, T. J., Martin, L. J., Zhang, X., Tandon, A., Benson, D. W., & Hinton, R. B. (2011) Risk factors for aortic valve disease in bicuspid aortic valve: A family-based study. American journal of medical genetics, 155(5), 1015–1020. doi: 10.1002/ajmg.a.33974.

Lunde, I. G. (2011) Molecular mechanisms of heart failure; Nuclear Factor of Activated T-cell (NFAT) signaling in myocardial hypertrophy and dysfunction. Dissertation for the degree of Philosophiae Doctor (PhD). Oslo, Norway. Series of dissertations submitted to the Faculty of Medicine, University of Oslo, №1307.

Wu, B., Baldwin, H. S., & Zhou, B. (2013) Nfatc1 directs the endocardial progenitor cells to make heart valve primordium. Trends in Cardiovascular Medicine, 23(8), 294–300. doi: 10.1016/j.tcm.2013.04.003.

Devereux, R. B., Alonso, D. R., Lutas, E. M., Gottlieb, G. J., Campo, E., Sachs, I., & Reichek, N. (1986) Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am. J. Cardiol., 57(6), 450–458. https://doi.org/10.1016/0002-9149(86)90771-X.

Gosse, P., Jullien, V., Jarnier, P., Lemetayer, P., & Clementy, J. (1999) Echocardiographic definition of left ventricular hypertrophy in the hypertensive: which method of indexation of left ventricular mass? J. Hum. Hypertens., 13(8), 505–9.

Ganau, A., Devereux, R. B., Roman, M. J., de Simone, G., Pickering, T. G., Saba, P. S., et al. (1992) Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. J. Am. Coll. Cardiol., 19(7), 1550–1558. doi: 10.1016/0735-1097(92)90617-V.•

Verdecchia, P., Porcellati, C., Zampi, I., Schillaci, G., Gatteschi, C., Battistelli, M., et al. (1994) Asymmetric left ventricular remodeling due to isolated septal thickening in patients with systemic hypertension and normal left ventricular masses. Am. J. Cardiol, 73(4), 247–52. doi: https://doi.org/10.1016/0002-9149(94)90228-3.

Downloads

How to Cite

1.
Kamenshchyk АV, Ivanko OG. Myocardial hypertrophy and intracardial hemodynamics in children with bicuspid aortic valve. Pathologia [Internet]. 2017Sep.27 [cited 2024Apr.18];(2). Available from: http://pat.zsmu.edu.ua/article/view/109296

Issue

Section

Original research