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Erschienen in: Pediatric Cardiology 3/2016

20.11.2015 | Original Article

Evaluation of Cardiovascular Changes in Children with BAVs

verfasst von: S. Hanedan Onan, A. Baykan, S. Sezer, F. Narin, E. Mavili, Z. Baykan, K. Uzum, N. Narin

Erschienen in: Pediatric Cardiology | Ausgabe 3/2016

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Abstract

The objectives of this study were to investigate left ventricular (LV) function, aortic dilation, and atherosclerosis in children with mildly deteriorated isolated bicuspid aortic valve (BAV) function using echocardiographic studies and biochemical markers of atherosclerosis and to correlate results with normal children. Biochemical analyses indicating cardiovascular risk of atherosclerosis and vascular changes in the aorta in relation to BAV were performed in 41 children aged 5–15 years old with isolated BAV and in 25 children with tricuspid aortic valves. Evaluations of aortic valve structures and functions; examinations of the LV M-mode and ascending aorta Doppler; and measurements of the LV Tei index (MPI), propagation velocity, ascending aorta at four levels, and carotid intima–media thickness (CIMT) were performed. There were no statistically significant differences in CIMTs, plasma matrix metalloproteinase-9, tissue metalloproteinase inhibitor-1 levels, or other biochemical parameters indicating cardiovascular risk or atherosclerosis between study and control groups. Deterioration of LV function, which could not be seen with M-mode echocardiography, was evident by MPI. MPI values in the study versus control groups were 0.46 ± 0.080 versus 0.40 ± 0.086 (p < 0.05). Diameters of the aorta in the study and control groups were 19.7 ± 4.7 and 17.2 ± 2.8 mm (p < 0.05) at the sinotubular junction level and 20.6 (14.4–40.5) and 18.3 (12.4–24) mm at the ascending aorta level (p < 0.05). Increased aortic valve insufficiency was related to increased aortic diameter. No sign of atherosclerosis was detected in children with BAV. Deterioration of LV function was seen using MPI, and aortic dilation was related to the severity of aortic valve insufficiency.
Literatur
1.
Zurück zum Zitat Abbas A, Grant PJ, Kearney MT (2008) Role of IGF-1 in glucose regulation and cardiovascular disease. Expert Rev Cardiovasc Ther 6(8):1135–1149CrossRefPubMed Abbas A, Grant PJ, Kearney MT (2008) Role of IGF-1 in glucose regulation and cardiovascular disease. Expert Rev Cardiovasc Ther 6(8):1135–1149CrossRefPubMed
2.
Zurück zum Zitat Aboulhosn J, Child JS (2006) Left ventricular outflow obstruction: subaortic stenosis, bicuspid aortic valve, supravalvar aortic stenosis, and coarctation of the aorta. Circulation 114:2412–2422CrossRefPubMed Aboulhosn J, Child JS (2006) Left ventricular outflow obstruction: subaortic stenosis, bicuspid aortic valve, supravalvar aortic stenosis, and coarctation of the aorta. Circulation 114:2412–2422CrossRefPubMed
3.
Zurück zum Zitat Bauer M, Siniawski H, Pasic M, Schaumann B, Hetzer R (2006) Different hemodynamic stress of the ascending aorta wall in patients with bicuspid and tricuspid aortic valve. J Card Surg 21:218–220CrossRefPubMed Bauer M, Siniawski H, Pasic M, Schaumann B, Hetzer R (2006) Different hemodynamic stress of the ascending aorta wall in patients with bicuspid and tricuspid aortic valve. J Card Surg 21:218–220CrossRefPubMed
4.
Zurück zum Zitat Bonderman D, Gharehbaghi-Schnell E, Wollenek G, Maurer G, Baumgartner H, Lang IM (1999) Mechanisms underlying aortic dilatation in congenital aortic valve malformation. Circulation 99:2138–2143CrossRefPubMed Bonderman D, Gharehbaghi-Schnell E, Wollenek G, Maurer G, Baumgartner H, Lang IM (1999) Mechanisms underlying aortic dilatation in congenital aortic valve malformation. Circulation 99:2138–2143CrossRefPubMed
5.
Zurück zum Zitat Bonow RO et al (2006) ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation 115:e409 Bonow RO et al (2006) ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation 115:e409
6.
Zurück zum Zitat Cantinotti M, Lopez L (2013) Nomograms for blood flow and tissue Doppler velocities to evaluate diastolic function in children: a critical review. J Am Soc Echocardiogr 26:126–141CrossRefPubMed Cantinotti M, Lopez L (2013) Nomograms for blood flow and tissue Doppler velocities to evaluate diastolic function in children: a critical review. J Am Soc Echocardiogr 26:126–141CrossRefPubMed
7.
Zurück zum Zitat Cecconi M, Nistri S, Quarti A, Manfrin M, Colonna PL, Molini E, Perna GP (2006) Aortic dilatation in patients with bicuspid aortic valve. J Cardiovasc Med (Hagerstown) 7:11–20CrossRef Cecconi M, Nistri S, Quarti A, Manfrin M, Colonna PL, Molini E, Perna GP (2006) Aortic dilatation in patients with bicuspid aortic valve. J Cardiovasc Med (Hagerstown) 7:11–20CrossRef
8.
Zurück zum Zitat Colao A (2008) The GH-IGF-I axis and the cardiovascular system: clinical implications. Clin Endocrinol (Oxf) 69:347–358CrossRef Colao A (2008) The GH-IGF-I axis and the cardiovascular system: clinical implications. Clin Endocrinol (Oxf) 69:347–358CrossRef
9.
Zurück zum Zitat Cui W, Roberson DA (2006) Left ventricular Tei index in children: comparison of tissue Doppler imaging, pulsed wave Doppler, and M-mode echocardiography normal values. J Am Soc Echocardiogr 19:1438–1445CrossRefPubMed Cui W, Roberson DA (2006) Left ventricular Tei index in children: comparison of tissue Doppler imaging, pulsed wave Doppler, and M-mode echocardiography normal values. J Am Soc Echocardiogr 19:1438–1445CrossRefPubMed
10.
Zurück zum Zitat Daniels SR, Loggie JM, Khoury P, Kimball TR (1998) Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertension. Circulation 97:1907–1911CrossRefPubMed Daniels SR, Loggie JM, Khoury P, Kimball TR (1998) Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertension. Circulation 97:1907–1911CrossRefPubMed
11.
Zurück zum Zitat Della Corte A, Romano G, Tizzano F, Amarelli C, De Santo LS, De Feo M, Scardone M, Dialetto G, Covino FE, Cotrufo M (2006) Echocardiographic anatomy of ascending aorta dilatation: correlations with aortic valve morphology and function. Int J Cardiol 113:320–326CrossRefPubMed Della Corte A, Romano G, Tizzano F, Amarelli C, De Santo LS, De Feo M, Scardone M, Dialetto G, Covino FE, Cotrufo M (2006) Echocardiographic anatomy of ascending aorta dilatation: correlations with aortic valve morphology and function. Int J Cardiol 113:320–326CrossRefPubMed
12.
Zurück zum Zitat Eidem BW, McMahon CJ, Cohen RR, Wu J, Finkelshteyn I, Kovalchin JP, Ayres NA, Bezold LI, O’Brian Smith E, Pignatelli RH (2004) Impact of cardiac growth on Doppler tissue imaging velocities: a study in healthy children. J Am Soc Echocardiogr 17:212–221CrossRefPubMed Eidem BW, McMahon CJ, Cohen RR, Wu J, Finkelshteyn I, Kovalchin JP, Ayres NA, Bezold LI, O’Brian Smith E, Pignatelli RH (2004) Impact of cardiac growth on Doppler tissue imaging velocities: a study in healthy children. J Am Soc Echocardiogr 17:212–221CrossRefPubMed
13.
Zurück zum Zitat El-Gendi SS, Bakeet MY, El-Hamed EA, Ibrahim FK, Ahmed R (2008) The value of lipoprotein (a), homocysteine, and Doppler of carotid and femoral arteries in assessment of atherosclerosis in asymptomatic cardiovascular risk patients. J Cardiol 52:202–211CrossRefPubMed El-Gendi SS, Bakeet MY, El-Hamed EA, Ibrahim FK, Ahmed R (2008) The value of lipoprotein (a), homocysteine, and Doppler of carotid and femoral arteries in assessment of atherosclerosis in asymptomatic cardiovascular risk patients. J Cardiol 52:202–211CrossRefPubMed
14.
Zurück zum Zitat Eto G, Ishii M, Tei C, Tsutsumi T, Akagi T, Kato H (1999) Assessment of global left ventricular function in normal children and in children with dilated cardiomyopathy. J Am Soc Echocardiogr 12:1058–1064CrossRefPubMed Eto G, Ishii M, Tei C, Tsutsumi T, Akagi T, Kato H (1999) Assessment of global left ventricular function in normal children and in children with dilated cardiomyopathy. J Am Soc Echocardiogr 12:1058–1064CrossRefPubMed
15.
Zurück zum Zitat Fedak PW, Verma S, David TE, Leask RL, Weisel RD, Butany J (2002) Clinical and pathophysiological implications of a bicuspid aortic valve. Circulation 106:900–904CrossRefPubMed Fedak PW, Verma S, David TE, Leask RL, Weisel RD, Butany J (2002) Clinical and pathophysiological implications of a bicuspid aortic valve. Circulation 106:900–904CrossRefPubMed
16.
Zurück zum Zitat Ferencik M, Pape LA (2003) Changes in size of ascending aorta and aortic valve function with time in patients with congenitally bicuspid aortic valves. Am J Cardiol 92:43–46CrossRefPubMed Ferencik M, Pape LA (2003) Changes in size of ascending aorta and aortic valve function with time in patients with congenitally bicuspid aortic valves. Am J Cardiol 92:43–46CrossRefPubMed
17.
Zurück zum Zitat Fernandes SM, Khairy P, Sanders SP, Colan SD (2007) Bicuspid aortic valve morphology and interventions in the young. J Am Coll Cardiol 49:2211–2214CrossRefPubMed Fernandes SM, Khairy P, Sanders SP, Colan SD (2007) Bicuspid aortic valve morphology and interventions in the young. J Am Coll Cardiol 49:2211–2214CrossRefPubMed
18.
Zurück zum Zitat Gautier M, Detaint D, Fermanian C, Aegerter P, Delorme G, Arnoult F, Milleron O, Raoux F, Stheneur C, Boileau C, Vahanian A, Jondeau G (2010) Nomograms for aortic root diameters in children using two-dimensional echocardiography. Am J Cardiol 105:888–894CrossRefPubMed Gautier M, Detaint D, Fermanian C, Aegerter P, Delorme G, Arnoult F, Milleron O, Raoux F, Stheneur C, Boileau C, Vahanian A, Jondeau G (2010) Nomograms for aortic root diameters in children using two-dimensional echocardiography. Am J Cardiol 105:888–894CrossRefPubMed
19.
Zurück zum Zitat Gibbons C, Dackor R, Dunworth W, Fritz-Six K, Caron KM (2007) Receptor activity-modifying proteins: RAMPing up adrenomedullin signaling. Mol Endocrinol 21:783–796CrossRefPubMed Gibbons C, Dackor R, Dunworth W, Fritz-Six K, Caron KM (2007) Receptor activity-modifying proteins: RAMPing up adrenomedullin signaling. Mol Endocrinol 21:783–796CrossRefPubMed
20.
Zurück zum Zitat Grotenhuis HB, Ottenkamp J, Westenberg JJ, Bax JJ, Kroft LJ, de Roos A (2007) Reduced aortic elasticity and dilatation are associated with aortic regurgitation and left ventricular hypertrophy in nonstenotic bicuspid aortic valve patients. J Am Coll Cardiol 49:1660–1665CrossRefPubMed Grotenhuis HB, Ottenkamp J, Westenberg JJ, Bax JJ, Kroft LJ, de Roos A (2007) Reduced aortic elasticity and dilatation are associated with aortic regurgitation and left ventricular hypertrophy in nonstenotic bicuspid aortic valve patients. J Am Coll Cardiol 49:1660–1665CrossRefPubMed
21.
Zurück zum Zitat Hashimoto I, Uese K, Watanabe S, Watanabe K, Hirono K, Ichida F, Miyawaki T (2007) Assessment of variables affecting flow propagation velocity of the left ventricle in healthy children. Pediatr Int 49:305–309CrossRefPubMed Hashimoto I, Uese K, Watanabe S, Watanabe K, Hirono K, Ichida F, Miyawaki T (2007) Assessment of variables affecting flow propagation velocity of the left ventricle in healthy children. Pediatr Int 49:305–309CrossRefPubMed
22.
Zurück zum Zitat Hinson JP, Kapas S, Smith DM (2000) Adrenomedullin, a multifunctional regulatory peptide. Endocr Rev 21:138–167PubMed Hinson JP, Kapas S, Smith DM (2000) Adrenomedullin, a multifunctional regulatory peptide. Endocr Rev 21:138–167PubMed
23.
Zurück zum Zitat Keane MG, Wiegers SE, Plappert T, Pochettino A, Bavaria JE, Sutton MG (2000) Bicuspid aortic valves are associated with aortic dilatation out of proportion to coexistent valvular lesions. Circulation 102((19 Suppl 3)):III35–III39PubMed Keane MG, Wiegers SE, Plappert T, Pochettino A, Bavaria JE, Sutton MG (2000) Bicuspid aortic valves are associated with aortic dilatation out of proportion to coexistent valvular lesions. Circulation 102((19 Suppl 3)):III35–III39PubMed
24.
Zurück zum Zitat Koullias GJ, Korkolis DP, Ravichandran P, Psyrri A, Hatzaras I, Elefteriades JA (2004) Tissue microarray detection of matrix metalloproteinases, in diseased tricuspid and bicuspid aortic valves with or without pathology of the ascending aorta. Eur J Cardiothorac Surg 26:1098–1103CrossRefPubMed Koullias GJ, Korkolis DP, Ravichandran P, Psyrri A, Hatzaras I, Elefteriades JA (2004) Tissue microarray detection of matrix metalloproteinases, in diseased tricuspid and bicuspid aortic valves with or without pathology of the ascending aorta. Eur J Cardiothorac Surg 26:1098–1103CrossRefPubMed
25.
Zurück zum Zitat Kullo IJ, Ballantyne CM (2005) Conditional risk factors for atherosclerosis. Mayo Clin Proc 80:219–230CrossRefPubMed Kullo IJ, Ballantyne CM (2005) Conditional risk factors for atherosclerosis. Mayo Clin Proc 80:219–230CrossRefPubMed
26.
Zurück zum Zitat Lamotte C, Iliescu C, Libersa C, Gottrand F (2011) Increased intima-media thickness of the carotid artery in childhood: a systematic review of observational studies. Eur J Pediatr 170:719–729CrossRefPubMed Lamotte C, Iliescu C, Libersa C, Gottrand F (2011) Increased intima-media thickness of the carotid artery in childhood: a systematic review of observational studies. Eur J Pediatr 170:719–729CrossRefPubMed
27.
Zurück zum Zitat Li H, Han M, Guo L, Li G, Sang N (2011) Oxidative stress, endothelial dysfunction and inflammatory response in rat heart to NO(2) inhalation exposure. Chemosphere 82:1589–1596CrossRefPubMed Li H, Han M, Guo L, Li G, Sang N (2011) Oxidative stress, endothelial dysfunction and inflammatory response in rat heart to NO(2) inhalation exposure. Chemosphere 82:1589–1596CrossRefPubMed
28.
Zurück zum Zitat Litwin M, Niemirska A (2009) Intima-media thickness measurements in children with cardiovascular risk factors. Pediatr Nephrol 24:707–719CrossRefPubMed Litwin M, Niemirska A (2009) Intima-media thickness measurements in children with cardiovascular risk factors. Pediatr Nephrol 24:707–719CrossRefPubMed
29.
Zurück zum Zitat Lopez-Candales A, Holmes DR, Liao S, Scott MJ, Wickline SA, Thompson RW (1997) Decreased vascular smooth muscle cell density in medial degeneration of human abdominal aortic aneurysms. Am J Pathol 150:993–1007PubMedPubMedCentral Lopez-Candales A, Holmes DR, Liao S, Scott MJ, Wickline SA, Thompson RW (1997) Decreased vascular smooth muscle cell density in medial degeneration of human abdominal aortic aneurysms. Am J Pathol 150:993–1007PubMedPubMedCentral
30.
Zurück zum Zitat Mangiafico RA, Malatino LS, Santonocito M, Spada RS (1998) Plasma endothelin-1 concentrations in non-insulin-dependent diabetes mellitus and nondiabetic patients with chronic arterial obstructive disease of the lower limbs. Int Angiol 17:97–102PubMed Mangiafico RA, Malatino LS, Santonocito M, Spada RS (1998) Plasma endothelin-1 concentrations in non-insulin-dependent diabetes mellitus and nondiabetic patients with chronic arterial obstructive disease of the lower limbs. Int Angiol 17:97–102PubMed
32.
Zurück zum Zitat Martin RM, Gunnell D, Whitley E, Nicolaides A, Griffin M, Georgiou N, Davey Smith G, Ebrahim S, Holly JM (2008) Associations of insulin-like growth factor (IGF)-I, IGF-II, IGF binding protein (IGFBP)-2 and IGFBP-3 with ultrasound measures of atherosclerosis and plaque stability in an older adult population. J Clin Endocrinol Metab 93:1331–1338CrossRefPubMed Martin RM, Gunnell D, Whitley E, Nicolaides A, Griffin M, Georgiou N, Davey Smith G, Ebrahim S, Holly JM (2008) Associations of insulin-like growth factor (IGF)-I, IGF-II, IGF binding protein (IGFBP)-2 and IGFBP-3 with ultrasound measures of atherosclerosis and plaque stability in an older adult population. J Clin Endocrinol Metab 93:1331–1338CrossRefPubMed
33.
Zurück zum Zitat Michelena HI, Desjardins VA, Avierinos JF, Russo A, Nkomo VT, Sundt TM, Pellikka PA, Tajik AJ, Enriquez-Sarano M (2008) Natural history of asymptomatic patients with normally functioning or minimally dysfunctional bicuspid aortic valve in the community. Circulation 117:2776–2784CrossRefPubMedPubMedCentral Michelena HI, Desjardins VA, Avierinos JF, Russo A, Nkomo VT, Sundt TM, Pellikka PA, Tajik AJ, Enriquez-Sarano M (2008) Natural history of asymptomatic patients with normally functioning or minimally dysfunctional bicuspid aortic valve in the community. Circulation 117:2776–2784CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Michowitz Y, Kisil S, Guzner-Gur H, Rubinstein A, Wexler D, Sheps D, Keren G, George J (2008) Usefulness of serum myeloperoxidase in prediction of mortality in patients with severe heart failure. Isr Med Assoc J 10:884–888PubMed Michowitz Y, Kisil S, Guzner-Gur H, Rubinstein A, Wexler D, Sheps D, Keren G, George J (2008) Usefulness of serum myeloperoxidase in prediction of mortality in patients with severe heart failure. Isr Med Assoc J 10:884–888PubMed
35.
Zurück zum Zitat Nistri S, Sorbo MD, Marin M, Palisi M, Scognamiglio R, Thiene G (1999) Aortic root dilatation in young men with normally functioning bicuspid aortic valves. Heart 82:19–22CrossRefPubMedPubMedCentral Nistri S, Sorbo MD, Marin M, Palisi M, Scognamiglio R, Thiene G (1999) Aortic root dilatation in young men with normally functioning bicuspid aortic valves. Heart 82:19–22CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Petko C, Minich LL, Everitt MD, Holubkov R, Shaddy RE, Tani LY (2010) Echocardiographic evaluation of children with systemic ventricular dysfunction treated with carvedilol. Pediatr Cardiol 31:780–784CrossRefPubMed Petko C, Minich LL, Everitt MD, Holubkov R, Shaddy RE, Tani LY (2010) Echocardiographic evaluation of children with systemic ventricular dysfunction treated with carvedilol. Pediatr Cardiol 31:780–784CrossRefPubMed
37.
Zurück zum Zitat Pettersen MD, Du W, Skeens ME, Humes RA (2008) Regression equations for calculation of z scores of cardiac structures in a large cohort of healthy infants, children, and adolescents: an echocardiographic study. J Am Soc Echocardiogr 21:922–934CrossRefPubMed Pettersen MD, Du W, Skeens ME, Humes RA (2008) Regression equations for calculation of z scores of cardiac structures in a large cohort of healthy infants, children, and adolescents: an echocardiographic study. J Am Soc Echocardiogr 21:922–934CrossRefPubMed
38.
Zurück zum Zitat Richey PA, Disessa TG, Somes GW, Alpert BS, Jones DP (2010) Left ventricular geometry in children and adolescents with primary hypertension. Am J Hypertens 23:24–29CrossRefPubMedPubMedCentral Richey PA, Disessa TG, Somes GW, Alpert BS, Jones DP (2010) Left ventricular geometry in children and adolescents with primary hypertension. Am J Hypertens 23:24–29CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Russo CF, Cannata A, Lanfranconi M, Vitali E, Garatti A, Bonacina E (2008) Is aortic wall degeneration related to bicuspid aortic valve anatomy in patients with valvular disease? J Thorac Cardiovasc Surg 136:937–942CrossRefPubMed Russo CF, Cannata A, Lanfranconi M, Vitali E, Garatti A, Bonacina E (2008) Is aortic wall degeneration related to bicuspid aortic valve anatomy in patients with valvular disease? J Thorac Cardiovasc Surg 136:937–942CrossRefPubMed
40.
Zurück zum Zitat Schaefer BM, Lewin MB, Stout KK, Gill E, Prueitt A, Byers PH, Otto CM (2008) The bicuspid aortic valve: an integrated phenotypic classification of leaflet morphology and aortic root shape. Heart 94:1634–1638CrossRefPubMed Schaefer BM, Lewin MB, Stout KK, Gill E, Prueitt A, Byers PH, Otto CM (2008) The bicuspid aortic valve: an integrated phenotypic classification of leaflet morphology and aortic root shape. Heart 94:1634–1638CrossRefPubMed
41.
Zurück zum Zitat Siu SC, Silversides CK (2010) Bicuspid aortic valve disease. J Am Coll Cardiol 55:2789–2800CrossRefPubMed Siu SC, Silversides CK (2010) Bicuspid aortic valve disease. J Am Coll Cardiol 55:2789–2800CrossRefPubMed
42.
Zurück zum Zitat Tham EB, Silverman NH (2004) Measurement of the Tei index: a comparison of M-mode and pulse Doppler methods. J Am Soc Echocardiogr 17:1259–1265CrossRefPubMed Tham EB, Silverman NH (2004) Measurement of the Tei index: a comparison of M-mode and pulse Doppler methods. J Am Soc Echocardiogr 17:1259–1265CrossRefPubMed
43.
Zurück zum Zitat Tzemos N, Lyseggen E, Silversides C, Jamorski M, Tong JH, Harvey P, Floras J, Siu S (2010) Endothelial function, carotid-femoral stiffness, and plasma matrix metalloproteinase-2 in men with bicuspid aortic valve and dilated aorta. J Am Coll Cardiol 55:660–668CrossRefPubMed Tzemos N, Lyseggen E, Silversides C, Jamorski M, Tong JH, Harvey P, Floras J, Siu S (2010) Endothelial function, carotid-femoral stiffness, and plasma matrix metalloproteinase-2 in men with bicuspid aortic valve and dilated aorta. J Am Coll Cardiol 55:660–668CrossRefPubMed
44.
Zurück zum Zitat Ucar T, Tutar E, Yalcinkaya F, Cakar N, Ozcakar ZB, Atalay S, Uncu N, Kara N, Ekim M (2008) Global left-ventricular function by tissue Doppler imaging in pediatric dialysis patients. Pediatr Nephrol 23:779–785CrossRefPubMed Ucar T, Tutar E, Yalcinkaya F, Cakar N, Ozcakar ZB, Atalay S, Uncu N, Kara N, Ekim M (2008) Global left-ventricular function by tissue Doppler imaging in pediatric dialysis patients. Pediatr Nephrol 23:779–785CrossRefPubMed
47.
Zurück zum Zitat Wilton E, Bland M, Thompson M, Jahangiri M (2008) Matrix metalloproteinase expression in the ascending aorta and aortic valve. Interact CardioVasc Thorac Surg 7:37–40CrossRefPubMed Wilton E, Bland M, Thompson M, Jahangiri M (2008) Matrix metalloproteinase expression in the ascending aorta and aortic valve. Interact CardioVasc Thorac Surg 7:37–40CrossRefPubMed
Metadaten
Titel
Evaluation of Cardiovascular Changes in Children with BAVs
verfasst von
S. Hanedan Onan
A. Baykan
S. Sezer
F. Narin
E. Mavili
Z. Baykan
K. Uzum
N. Narin
Publikationsdatum
20.11.2015
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 3/2016
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-015-1302-6

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