OS 24-05 IMPAIRED VASCULAR FUNCTION OF AORTA IN ADOLESCENT WITH TURNER SYNDROME

Abstract

Objective: Aortic dilatation and dissection are complications in some Turner syndrome (TS) patients. To better understand vascular nature of aorta before adult, we evaluated several elastic properties of the aorta in adolescent with TS in comparison to healthy controls. Design and Method: Various indices of the vascular function of ascending aorta were assessed prospectively in TS (n = 28), with a mean age of 14.9 ± 3.3 years and age-matched control (n = 18) groups with the transthoracic echocardiography. Results: Blood pressures (BPs) were higher in TS patients than control groups (122 vs. 108 mmHg, p = 0.002; 73 vs. 62, p < 0.001). Aortic stiffness index was greater in the TS patients than in control group (7.07 ± 5.89 vs 3.33 ± 1.14, p = 0.014) and aortic distensibility and strain were significantly lower in TS group compared with controls (0.0047 ± 0.002 vs. 0.0081 ± 0.003, p = 0.002; 0.1167 ± 0.069 vs. 0.1865 ± 0.049, p = 0.003). The fractional area change (%) by velocity vector imaging (FAC by VVI) was lower in TS than control groups (28.25 ± 6.21 vs. 36.18 ± 6.83, p = 0.001). Even after correcting for body mass index and systolic BP, aortic distensibility and strain, and FAC by VVI showed negative association with TS (β = −0.44, p = 0.011; β = −0.478, p = 0.009; β = −0.48, p = 0.007). The diameter of ascending aorta was not significantly different between TS and control group. Conclusions: The structural change of aorta was not definite in adolescent patients with TS when compared with control subjects but functional vascular change precedes the structural change. It suggests the requirement of the meticulous follow-up in TS patients from the adolescent period.