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.

Keywords: Aortic valve/abnormalities, echocardiography, elasticity; electrocardiography/methods; heart conduction system; heart defects, congenital