Bicuspid Aortic Valve: Differences between Populations in Israel

Congenital bicuspid aortic valve (BAV) is the most common congenital valve abnormality, with an estimated incidence of 0.5-2% in adults. However, BAV is much less prevalent in some populations and racial differences were reported.

Aim: Comparison between Arab and Jewish patients with BAV in Israel. Methods: Screening of 19000 echocardiographic studies in Bnai Zion Medical Center and evaluation of demographic, atherosclerotic risk factors, clinical and echocardiographic parameters was performed.

Results: Male to female ratio in Arab patients was 4.6:1 while in Jewish patients 1.6:1, p<0.01. The age of both populations with BAV was similar 45±21yeras, however larger prevalence was found of cigarette smoking and diabetes mellitus in Arabs 31.1% and 6.7% than in Jews 8.2% and 3.5% respectively, p<0.05. Left ventricular, left atrial and aortic dimensions as well as Doppler parameters were similar in both groups except for large mitral peak A-wave velocities in Jewish patients. Prevalence of aortic valve stenosis in Jewish patients was 35% similar to that in Arabs 33% with similar severity and mean pressure gradients. Aortic valve regurgitation was fond in 53% of Arab patients and in 46% of Jewish patients, p=ns, however, moderately severe and severe aortic regurgitation was more prevalent in Arab patients 22% compared to 13% of Jewish patients, p<0.05.

Conclusion: Male to female ratio in Arab patients with BAV is larger and with higher prevalence of moderately severe to severe aortic regurgitation compared to Jewish patients.