BackgroundBicuspid aortic valve (BAV) is prone to promote the occurrence of left ventricular remodeling (LVR) which is associated with adverse clinical outcomes. Although the association between angiogenic activity and LVR has been established, pro-angiogenic cytokine features and potential biomarker candidates for LVR in BAV patients remain to be clarified. MethodsFrom November 2018 to May 2019, BAV patients diagnosed by transthoracic echocardiography at our institution were included. LVR was diagnosed based on echocardiographic calculations of relative wall thickness (RWT) and left ventricular mass index (LVMI). A multiplex ELISA array was used to measure the plasma levels of 60 angiogenesis-related cytokines. ResultsAmong 103 BAV patients, 71 were categorized into LVR group and 32 into normal LV geometry group. BAV patients with LVR demonstrated increased LVMI, elevated prevalence of moderate to severe aortic stenosis and aortic regurgitation, and decreased left ventricular ejection fraction (LVEF). Plasma level of Angiopoietin-1 was elevated in BAV patients with or without LVR compared to healthy controls (P = 0.001, P < 0.001, respectively) and was negatively correlated with RWT (r = -0.222, P = 0.027). Plasma level of Angiopoietin-2 was elevated in the LVR group (P = 0.001) compared to normal LV geometry group and was negatively correlated with LVEF (r = -0.330, P = 0.002). ConclusionDecreased angiogenesis plays a crucial role in the occurrence and progression of LVR in BAV patients. Disturbance in the pro- and anti-angiogensis equilibrium in BAV patients with LVR may reflect the aggravation of endothelial injury and dysfunction.