Assessment of P-wave dispersion in patients with isolated bicuspid aortic valve and its relationship with aortic elasticity

OBJECTIVES
We evaluated P-wave duration and P-wave dispersion (PWD) in patients with isolated bicuspid aortic valve (BAV) without significant valve dysfunction and investigated the relationship between P-wave measurements and aortic elasticity.

STUDY DESIGN
This prospective study consisted of 39 patients with isolated BAV with normal ejection fraction and 29 age- and gender-matched healthy subjects. P-wave duration and P-wave dispersion were calculated on 12- lead electrocardiograms. Echocardiographic examination was performed and aortic elasticity parameters were calculated including aortic strain, aortic stiffness index, aortic distensibility, and aortic elastic modulus.

RESULTS
Patients with BAV had significantly greater Pmax and PWD compared to controls (128±11 vs. 115±11 msec, p=0.006; 70±10 vs. 66±13 msec, p=0.02, respectively), whereas Pmin was similar. Aortic strain and distensibility were significantly lower and aortic stiffness index and aortic elastic modulus were significantly greater in patients with BAV (for all, p=0.0001). In correlation analysis, Pmax was significantly correlated with aortic strain (r=-0.30, p=0.01), aortic distensibility (r=-0.27, p=0.02), aortic stiffness index (r=0.36, p=0.004), and aortic elastic modulus (r=0.38, p=0.003), while PWD was correlated with aortic strain (r=-0.23, p=0.05) and aortic elastic modulus (r=0.25, p=0.05).

CONCLUSION
Our data showed that isolated BAV without valve dysfunction was associated with prolonged Pwave duration and increased PWD, both of which were related to aortic elasticity parameters.