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
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
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二叶式主动脉瓣患者的升主动脉增大和弹性特性受损与内皮功能障碍和血浆基质金属蛋白酶 2 水平升高有关。
DOI：
10.1016/j.ultrasmedbio.2018.01.012
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发表时间：
2018-05-01
影响因子：
2.9
通讯作者：
Zhou, Wei
中科院分区：
文献类型：
--
作者：
Wang, Yi-Bin;Li, Yang;Zhou, Wei
本研究的目的是检测升主动脉的尺寸增大和弹性受损是否与无明显瓣膜功能障碍的二叶式主动脉瓣（BAV）患者的内皮功能受损和血浆基质金属蛋白酶（MMP）-2浓度升高相关。应用二维超声心动图和高频线性超声对42例无明显瓣膜功能障碍的BAV患者和30例年龄和性别匹配的健康对照者的升主动脉的大小和弹性以及充血时肱动脉的血流介导的血管舒张（FMD）进行了评价。在BAV组中，舒张期升主动脉直径（AoD）（32.1 ± 8.1 mm vs. 25.3 ± 3.6 mm，p < 0.001）和主动脉僵硬指数（8.0 +/- 5.3 vs. 4.0 +/- 1.8，p < 0.001）显著较高，主动脉应变（7.4 ± 3.6% vs. 11.1 ± 3.0%，p < 0.001）和主动脉扩张性（7.4 +/- 4.1 x 10（-6）cm（2）/dyn vs. 11.1 +/- 4.3 x 10（-6）cm（2）/dyn，p < 0.001）显著低于对照组。与对照组相比，BAV组还具有较低的FMD（6.5 +/- 2.2% vs. 11.9 +/-2.7%，p < 0.001）和较高的血浆MMP-2水平（226.7 +/- 55.0 ng/mL vs. 177.0 +/- 45.3 ng/mL，p < 0.001）。在BAV组中，AoD、主动脉应变、主动脉僵硬指数和主动脉扩张性与FMD和MMP-2显著相关（均p < 0.05）。多变量线性回归分析进一步表明，FMD和MMP-2与AoD独立相关（分别为β =-1.1，p = 0.005和β = 0.09，p < 0.001）。这些结果表明，在无明显瓣膜功能障碍的BAV患者中，升主动脉的尺寸增大和弹性受损与内皮功能障碍和血浆MMP-2水平升高相关。FMD和血浆MMP-2水平是BAV患者升主动脉扩张的重要和独立的预测因素。（E-mail：ybdeng2007@hotmail.com）（c）2018年世界医学和生物学超声联合会。All rights reserved.
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 x 10(-6)cm(2)/dyn vs. 11.1 +/- 4.3 x 10(-6)cm(2)/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 (beta = -1.1, p = 0.005, and beta = 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. (E-mail: ybdeng2007@hotmail.com) (c) 2018 World Federation for Ultrasound in Medicine & Biology. All rights reserved.