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PP.06.21: THE MODIFIED FACTORS IN THORACIC AORTIC ANEURYSM DEVELOPMENT

Objective: The aim of the study was to identify the main risk factors, which determine the progression of thoracic aorta(TA) dilatation. Design and method: 94 pts with TA dilatation and 50 pts with risk factors and without aortic pathology were examined. In basic group 25 pts had bicuspid aortic valves (BAV) (mean age 52.5+/- 8.4 yrs) and 69 pts had tricuspid valves (TAV) (mean age 59.3+/- 7.7). The aorta size was estimated according to the standard ECHO protocol (Vivid 7). Lipid profile, homocysteine, glucose, insulin, CRP levels were done. Arterial stiffness was assessed by SphygmoCor device (Australia) using indirect carotid-femoral distance. Results: Positive correlation between the aorta maximum diameter index and augmentation index was revealed (r = 0.284; p = 0.0096), especially in pts with TAV (r = 0.443;p = 0.0003). Instead low pulse wave velocity in BAV pts correlation between augmentation index and index of aortic root was identified (r = 0.431; p = 0.02). Besides, positive correlation between peripheral pulse pressure and aorta diameter at the level of sinus of Valsalva were found in BAV pts (r = 0.550; p = 0.012). The association between ascending aorta diameter and lipid pattern indication, glucose level, insulin at TAV and BAV pts group was not revealed. At once, the positive correlative relationship between aorta diameter index on the sinus of Valsava and the level of homocysteine in blood serum (r = 0.246; p = 0.004) was determined. It is found that aorta diameter increase on the sino-tubular junction was associated with serum ADMA in TAV and BAV pts (r = 0.227; p = 0.013) Conclusions: Besides, haemodynamic factors are important changes of vascular wall stiffness in the pathogenesis of TA dilatation. Due to the lowpulse wave velocity in patients with BAV, aortopathy can not be excluded as the cause of aortic dilatation. Endothelial dysfunction is an additional factor of TA aneurysm development.