Abstract 13179: Bicuspid Aortic Valve in African Americans is Associated with Smaller Aortic Dimensions Despite Greater Prevalence of Hypertension
Bicuspid aortic valve (BAV) is associated with increased risk for aortic dilation, valve dysfunction and acute aortic events. Genetic causes and abnormal hemodynamic flow patterns are considered risk factors. To date, little is known about BAV in African Americans (AAs). The aim of this study was to evaluate the size of the aorta in AAs with BAV, as this may indicate genetic contributions to the susceptibility for aortic disease associated with BAV. By querying our adult ECHO database from 1998-2009 we identified 177 AA or caucasians with complete data set obtained by chart review (race, age, height, weight, hypertension, dyslipidemia, chronic kidney disease, and medication use). The most recent or last pre-surgical study was reviewed for prospective measurements of (i) aortic annulus, sinus of valsalva, sino-tubular junction, and ascending aorta 3 cm distal to the annulus, (ii) LV dimension and ejection fraction, and (iii) severity of aortic stenosis (AS) and aortic regurgitation (AR). Multiple linear regression analysis was performed.
Results: Of the 177 included patients, 41 (23.2%) were AA and 136 caucasian. There were no differences with regard to height, weight, sex, dyslipidemia, and kidney dysfunction with the exceptions: AAs were older (49.9 years vs 43.2 p=0.03), and more hypertensive (51.2% and 24.3%, p=0.001). However, use of ARB/ACEi and BB was similar. LV size and function, BAV morphology and severity of AS/AR were similar, with a trend toward decreased presence of AS/AR in AAs (p=0.067). AAs had smaller aortic dimensions at the annulus (p=0.001), sinus (p=0.07), sino-tubular junction (p=0.001), and ascending aorta (p=0.06) and these differences were even more pronounced after adjusting for age and hypertension (Table 1).
Conclusion: African Americans with BAV have smaller proximal ascending aortas compared to caucasians with BAV. This racial difference in aortic dimensions is highly suggestive of a genetic basis for aortic dilation in patients with BAV.
- © 2011 by American Heart Association, Inc.