Aortic valve function and aortic dimensions in obese and overweight patients with bicuspid aortic valve

Introduction: Bicuspid aortic valve is the most common CHD and commonly associated with activity restrictions that may lead to a sedentary lifestyle known to increase obesity risk. It is unknown whether obesity is associated with changes in aortic dimensions or aortic valve function in young people with bicuspid aortic valve. This study investigates whether overweight and obese children with bicuspid aortic valve have worse aortic valve function or increased aortic dimensions compared to healthy weight children with bicuspid aortic valve.Methods: This was a single centre retrospective cohort study comprised of patients 5 to 25 years old with a diagnosis of bicuspid aortic valve between 1 January, 2019 and 31 December, 2020. Patients were classified as healthy weight or overweight/obese. Values for aortic dimensions as well as peak and mean aortic valve gradients were obtained from echocardiogram reports.Results: About 251 patients were analysed. Demographics were similar between groups. When indexed to height, the aortic valve annulus (1.28 +/- 0.14 vs. 1.34 +/- 0.15, p = 0.001) and sinotubular junctions (1.44 +/- 0.21 vs. 1.49 +/- 0.24, p = 0.038) were larger in the overweight/obese group, with no differences in aortic root or ascending aorta sizes. The obese/overweight group had a higher peak aortic valve gradient (23.03 +/- 1.64 mmHg vs. 16.17 +/- 1.55 mmHg, p = 0.003) compared to the healthy weight group.Conclusion: Healthy weight patients did not have larger aortic dimensions compared to the overweight/obese patients. There was evidence of worsening aortic valve stenosis in overweight/obese patients compared to those at a healthy weight.