Enlarged Size and Impaired Elastic Properties of the Ascending Aorta are Associated with Endothelial Dysfunction and Elevated Plasma Matrix Metalloproteinase-2 Level in Patients with Bicuspid Aortic Valve

Yi-Bin Wang; Yang Li; You-Bin Deng; Ya-Ni Liu; Jun Zhang; Jie Sun; Ying Zhu; Li Li; Qiao-Ying Tang; Wei Zhou

doi:10.1016/j.ultrasmedbio.2018.01.012

Enlarged Size and Impaired Elastic Properties of the Ascending Aorta are Associated with Endothelial Dysfunction and Elevated Plasma Matrix Metalloproteinase-2 Level in Patients with Bicuspid Aortic Valve

Ultrasound Med Biol. 2018 May;44(5):955-962. doi: 10.1016/j.ultrasmedbio.2018.01.012. Epub 2018 Feb 20.

Authors

Yi-Bin Wang¹, Yang Li², You-Bin Deng³, Ya-Ni Liu¹, Jun Zhang¹, Jie Sun¹, Ying Zhu¹, Li Li¹, Qiao-Ying Tang¹, Wei Zhou¹

Affiliations

¹ Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Department of Medical Ultrasound, the First Affiliated Hospital of Bengbu Medical College, Bengbu, China.
³ Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: ybdeng2007@hotmail.com.

PMID: 29472114
DOI: 10.1016/j.ultrasmedbio.2018.01.012

Abstract

The aim of this study was to test whether enlarged size and impaired elastic properties of the ascending aorta are associated with impaired endothelial function and increases in plasma matrix metalloproteinase (MMP)-2 concentrations in patients with bicuspid aortic valve (BAV) without significant valvular dysfunction. The size and the elasticity of the ascending aorta and the flow-mediated vasodilation (FMD) in the brachial artery in response to hyperemia were evaluated with 2-D echocardiography and high-frequency linear ultrasound in 42 patients with BAV without significant valvular dysfunction and 30 age- and sex-matched healthy controls. In the BAV group, diastolic ascending aortic diameter (AoD) (32.1 ± 8.1 mm vs. 25.3 ± 3.6 mm, p <0.001) and aortic stiffness index (8.0 ± 5.3 vs. 4.0 ± 1.8, p <0.001) were significantly higher, and aortic strain (7.4 ± 3.6% vs. 11.1 ± 3.0%, p <0.001) and aortic distensibility (7.4 ± 4.1 × 10^-6cm²/dyn vs. 11.1 ± 4.3 × 10^-6cm²/dyn, p <0.001) were significantly lower than those in the control group. The BAV group also had lower FMD (6.5 ± 2.2% vs. 11.9 ± 2.7%, p <0.001) and higher plasma MMP-2 levels (226.7 ± 55.0 ng/mL vs. 177.0 ± 45.3 ng/mL, p <0.001) compared with the control group. In the BAV group, AoD, aortic strain, aortic stiffness index and aortic distensibility significantly correlated with FMD and MMP-2 (all p <0.05). The multivariable linear regression analysis further indicated that FMD and MMP-2 were independently associated with AoD (β = -1.1, p = 0.005, and β = 0.09, p <0.001, respectively). These findings suggest that enlarged size and impaired elastic properties of the ascending aorta are associated with endothelial dysfunction and elevated plasma MMP-2 level in patients with BAV without significant valvular dysfunction. FMD and plasma MMP-2 level are the significant and independent predictors of dilation of the ascending aorta in patients with BAV.

Keywords: Bicuspid aortic valve; Echocardiography; Endothelial function; Nitric oxide.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aorta / diagnostic imaging*
Aorta / pathology*
Aortic Valve / abnormalities*
Aortic Valve / diagnostic imaging
Aortic Valve / pathology
Bicuspid Aortic Valve Disease
Cross-Sectional Studies
Echocardiography / methods
Endothelium, Vascular / diagnostic imaging
Endothelium, Vascular / pathology*
Female
Heart Valve Diseases / blood*
Heart Valve Diseases / diagnostic imaging
Heart Valve Diseases / pathology*
Humans
Male
Matrix Metalloproteinase 2 / blood*
Middle Aged
Ultrasonography / methods
Vascular Stiffness
Young Adult

Substances

Matrix Metalloproteinase 2