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Aortic elasticity and carotid intima-media thickness in children with mitral valve prolapse

Published online by Cambridge University Press:  07 November 2017

Elif Erolu ,
Figen Akalın ,
Nilüfer Çetiner  and
Berna Şaylan Çevik
Elif Erolu*
Affiliation:
Department of Pediatrics, Divisions of Pediatric Cardiology, Marmara University Faculty of Medicine, İstanbul, Turkey
Figen Akalın
Affiliation:
Department of Pediatrics, Divisions of Pediatric Cardiology, Marmara University Faculty of Medicine, İstanbul, Turkey
Nilüfer Çetiner
Affiliation:
Department of Pediatrics, Divisions of Pediatric Cardiology, Marmara University Faculty of Medicine, İstanbul, Turkey
Berna Şaylan Çevik
Affiliation:
Department of Pediatrics, Divisions of Pediatric Cardiology, Marmara University Faculty of Medicine, İstanbul, Turkey
*
Correspondence to: E. Erolu, Department of Pediatrics, Divisions of Pediatric Cardiology, Marmara University Faculty of Medicine, Fevzi Çakmak Mah. Muhsin Yazıcıoğlu Cad. No: 10 Üst Kaynarca, Pendik, Istanbul 34662, Turkey. Tel: +90 505 816 94 56; Fax: +90 216 632 71 21; E-mail: [email protected]
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Abstract

Aim

We aimed to study the dimensions, systolic and diastolic functions of the left ventricle; dimensions and elasticity of the aorta; and carotid intima-media thickness and flow-mediated dilatation of the brachial artery in mitral valve prolapse.

Methods

The study group consisted of 43 patients (mean age=13.3±3.9) and 42 healthy children (mean age=12.9±3.4). Left ventricular end-diastolic, end-systolic, left atrial diameters, interventricular septum, and left ventricular posterior wall thickness were measured. Ejection and shortening fractions were calculated by M-mode. Measurements were adjusted to the body surface area. Mitral annulus, and systolic and diastolic diameters of the aortic annulus and aorta at each level were obtained; z-scores, aortic strain, distensibility, stiffness index were calculated. Carotid intima-media thickness and flow-mediated dilatation were studied. Patients were classified as classical/non-classical mitral valve prolapse and younger/older patients.

Results

Left ventricular end-systolic, end-diastolic, and left atrial diameters (p=0.009, p=0.024, p=0.001) and aortic z-scores at annulus, sinus valsalva, and sinotubuler junction were larger (p=0.008, p=0.003, p=0.002, respectively) in the mitral valve prolapse group. Aortic strain and distensibility increased and stiffness decreased at the ascending aorta in the patient group (p=0.012, 0.020, p=0.019, respectively). Classical mitral valve prolapse had lower strain and distensibility and higher stiffness of the aorta at sinus valsalva level (p=0.010, 0.027, 0.004, respectively). Carotid intima-media thickness was thinner in the patient group, especially in the non-classical mitral valve prolapse group (p=0.037). Flow-mediated dilatation did not differ among the groups.

Conclusion

Mitral valve prolapse is a systemic disease of the connective tissue causing enlarged cardiac chambers and increased elasticity of the aorta. Decreased carotid intima-media thickness in this group may indicate low atherosclerosis risk.

Keywords

Mitral valve prolapsechildrenaortic elasticitycarotid intima-media thickness
Type
Original Articles
Information
Cardiology in the Young , Volume 28 , Issue 2 , February 2018 , pp. 292 - 301
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Copyright
© Cambridge University Press 2017 

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