Publication details
Kardiovaskulární parametry u pacientů s bikuspidální aortální chlopní získané sfygmografií a kontinuálním měřením – pilotní studie
| Title in English | Cardiovascular Parameters in Patients with Bicuspid Aortic Valve Obtained by Sphygmography and Continuous Measurement – A Pilot Study |
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| Authors | |
| Year of publication | 2025 |
| Type | Conference abstract |
| Citation | |
| Description | Bicuspid aortic valve (BAV) is the most common congenital heart defect, occurring in 1–2% of the population. This anomaly represents a significant risk factor for the development of aortic valve and ascending aorta pathologies. Patients with BAV frequently develop aortic stenosis or regurgitation, dilation of the aortic root or its ascending part, or infectious endocarditis. Dilation of the ascending aorta occurs in 50–60% of patients with a normally functioning BAV and has a progressive nature. The risk of aortic dissection in these patients is up to nine times higher than in individuals with a tricuspid valve. The aim of the study was to determine the basic cardiovascular system parameters in patients with BAV using continuous blood pressure measurement according to Peňáz, electrocardiography (ECG), and sphygmography, and to compare them with those of a healthy population. In collaboration with the Center for Cardiovascular and Transplant Surgery, we examined 73 patients with BAV (aged 22–56 years). All participants underwent a six-minute resting continuous blood pressure measurement according to Penáz with ECG recording (Finapres NOVA device, FMS, Netherlands). The parameters monitored included systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate interval (HRI), and hemodynamic parameters such as stroke volume (SV), cardiac index (CI), contractility index (dP/dt), and autonomic nervous system function assessed through baroreflex sensitivity (BRS) and variability evaluation using the low-to-high frequency ratio (LF/HF). Additionally, vascular characteristics were assessed using the SphygmoCor device (AtCor Medical, Australia), including carotid-femoral pulse wave velocity (PWVcf), augmentation pressure (AP), augmentation index standardized to a heart rate of 75 bpm (AI/75), and the subendocardial viability ratio (SEVR). The measured physiological values (mean ± standard deviation) for the parameters were as follows: SBP: 128 ± 13 mmHg, DBP: 72 ± 10 mmHg, HRI: 968 ± 159 ms, CI: 3.5 ± 1.0 L/min/m2, BRS: 12.7 ± 7.1 ms/mmHg. Elevated values were observed for: SV (110 ± 33 mL). Reduced values were observed for: dP/dt (852 ± 301 mmHg/s), LF/HF (0.8 ± 0.6). Vascular parameters were as follows: PWVcf: 5.0 ± 1.2 m/s, AP: 12.8 ± 9.4 mmHg, AI/75: 21.9 ± 14.6% (elevated), SEVR: 141.4 ± 29.6% (borderline values). Our results indicate that despite standard treatment for this condition, patients with BAV exhibit pathological values that are crucial for proper heart function—namely, an increased stroke volume, a decreased contractility index, and reduced variability. In terms of vascular characteristics, borderline SEVR values suggest potential impairment in endocardial perfusion. These are preliminary results obtained through continuous monitoring, which we aim to compare with ultrasound measurements. The combined use of these methods could help further individualize and refine treatment for these patients, ultimately reducing the risk of sudden aortic dissection. |
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