Evaluation of Pulse Wave Velocity using Transthoracic Echocardiography in Children with Bicuspid Aortic Valve

Background  Increased aortic stiffness in patients with bicuspid aortic valve (BAV) may significantly affect morbidity and mortality.

Objective  We aimed to evaluate aortic elasticity properties and the usability of the new technique by measuring pulse wave velocity (PWV) with a transthoracic echocardiography device in patients with BAV.

Methods  Fifty patients with BAV and 50 healthy children with similar demographic characteristics were included in this study. Patients with BAV were grouped according to fused cusp morphology. Valve function was normal or near normal in the patients with BAV included in the study. All patients’ left ventricular function, aortic root diameter, and aortic elasticity characteristics were evaluated. A p-value <0.05 was considered significant.

Results  PWV was significantly higher in the BAV group (p=0.000). Aortic elasticity parameters obtained from ascending aorta diameters were similar between the groups. Ascending aorta diameters were significantly higher in the BAV group. There was a correlation between PWV, ascending aortic diameter, vena contracta in aortic regurgitation, and peak aortic velocity. PWV inter- and intraobserver reliability alpha values were 0.92 and 0.84, respectively.

Conclusions  In the pediatric BAV group with normal or near-normal valve function, although aortic elasticity parameters were normal with conventional measurements based on ascending aorta diameters, PWV measurements with the same device were significantly higher without the need for an additional apparatus or program, and aortic stiffness increased in the BAV group. PWV measurement by echocardiography is a reliable and reproducible technique.

Keywords
Bicuspid Aortic Valve Disease; Child; Pulse Wave Analysis

Central Illustration:
Evaluation of Pulse Wave Velocity using Transthoracic Echocardiography in Children with Bicuspid Aortic Valve