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Aortic Dilatation in Pediatric Patients with Bicuspid Aortic Valve: How the Choice of Nomograms May Change Prevalence.
Spaziani, Gaia; Bonanni, Francesca; Girolami, Francesca; Bennati, Elena; Calabri, Giovanni Battista; Di Filippo, Chiara; Porcedda, Giulio; Passantino, Silvia; Nistri, Stefano; Olivotto, Iacopo; Favilli, Silvia.
Afiliación
  • Spaziani G; Pediatric and Transition Cardiology, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy.
  • Bonanni F; Department of Experimental and Clinical Medicine, University of Florence, 50100 Firenze, Italy.
  • Girolami F; Pediatric and Transition Cardiology, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy.
  • Bennati E; Pediatric and Transition Cardiology, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy.
  • Calabri GB; Pediatric and Transition Cardiology, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy.
  • Di Filippo C; Pediatric and Transition Cardiology, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy.
  • Porcedda G; Pediatric and Transition Cardiology, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy.
  • Passantino S; Pediatric and Transition Cardiology, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy.
  • Nistri S; Cardiology Service, CMSR Veneto Medica, 36077 Altavilla Vicentina, Italy.
  • Olivotto I; Pediatric and Transition Cardiology, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy.
  • Favilli S; Department of Experimental and Clinical Medicine, University of Florence, 50100 Firenze, Italy.
Diagnostics (Basel) ; 13(8)2023 Apr 20.
Article en En | MEDLINE | ID: mdl-37189592
ABSTRACT

BACKGROUND:

Aortic dilation (AoD) is commonly reported in patients with bicuspid aortic valve (BAV) and has been related to flow abnormalities and genetic predisposition. AoD-related complications are reported to be extremely rare in children. Conversely, an overestimate of AoD related to body size may lead to excess diagnoses and negatively impact quality of life and an active lifestyle. In the present study, we compared the diagnosis performance of the newly introduced Q-score (based on a machine-learning algorithm) versus the traditional Z-score in a large consecutive pediatric cohort with BAV. MATERIALS AND

METHODS:

Prevalence and progression of AoD were evaluated in 281 pediatric patients ages > 5 and < 18 years at first observation, 249 of whom had isolated BAV and 32 had BAV associated with aortic coarctation (CoA-BAV). An additional group of 24 pediatric patients with isolated CoA was considered. Measurements were made at the level of the aortic annulus, Valsalva sinuses, sinotubular aorta, and proximal ascending aorta. Both Z-scores using traditional nomograms and the new Q-score were calculated at baseline and at followup (mean 4.5 years).

RESULTS:

A dilation of the proximal ascending aorta was suggested by traditional nomograms (Z-score > 2) in 31.2% of patients with isolated BAV and 18.5% with CoA-BAV at baseline and in 40.7% and 33.3%, respectively, at followup. No significant dilation was found in patients with isolated CoA. Using the new Q-score calculator, ascending aorta dilation was detected in 15.4% of patients with BAV and 18.5% with CoA-BAV at baseline and in 15.8% and 3.7%, respectively, at followup. AoD was significantly related to the presence and degree of aortic stenosis (AS) but not to aortic regurgitation (AR). No AoD-related complications occurred during the followup.

CONCLUSIONS:

Our data confirm the presence of ascending aorta dilation in a consistent subgroup of pediatric patients with isolated BAV, with progression during followup, while AoD was less common when CoA was associated with BAV. A positive correlation was found with the prevalence and degree of AS, but not with AR. Finally, the nomograms used may significantly influence the prevalence of AoD, especially in children, with a possible overestimation by traditional nomograms. This concept requires prospective validation in long-term followup.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Tipo de estudio: Prevalence_studies / Risk_factors_studies Idioma: En Revista: Diagnostics (Basel) Año: 2023 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Tipo de estudio: Prevalence_studies / Risk_factors_studies Idioma: En Revista: Diagnostics (Basel) Año: 2023 Tipo del documento: Article País de afiliación: Italia