Arterial Stiffness in Aortic Stenosis: Relationship with Severity and Echocardiographic Procedures Response

Bruschi, Giuseppe; Maloberti, Alessandro; Scocco, Paola; Colombo, Giulia; Nava, Stefano; Vallerio, Paola; Casadei, Francesca; Bruno, Jolie; Moreo, Antonella; Merlanti, Bruno; Russo, Claudio; Oliva, Fabrizio; Klugmann, Silvio; Giannattasio, Cristina

doi:10.1007/s40292-016-0176-x

Cited by 16 publications

(26 citation statements)

References 24 publications

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“…Bruschi et al reported elevated cfPWV in patients with AS undergoing AVR (surgical or transcatheter). 22 The cfPWV increased with increasing aortic valve MPG. In another study using invasive measurement of aortic stiffness, aorto-femoral PWV strongly correlated with MPG and the extent of aortic valve calcification.…”

Section: Discussionmentioning

confidence: 95%

“…Several different parameters have been used to quantify LV afterload in patients with severe AS. 18 , 20 , 21 , 22 , 34 , 37 The most commonly used among these are ZVa, effective arterial elastance and total arterial compliance. It has been demonstrated that the patients with low-flow, severe AS have increased ZVa and effective arterial elastance whereas total arterial compliance is reduced.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, very limited data is available about arterial stiffness in AS and no previous study has evaluated its relationship with LVSVi. 20 , 21 , 22 The present study was therefore sought to study the effect of arterial stiffness on LVSVi and aortic valve gradients in patients with severe AS.…”

Section: Introductionmentioning

confidence: 99%

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Aortic pulse wave velocity and its relationship with transaortic flow and gradients in patients with severe aortic stenosis undergoing aortic valve replacement

Ranjan

Grewal

Kasliwal

et al. 2020

Indian Heart Journal

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Background Low-flow, low-gradient severe aortic stenosis (LFLGAS) is a common clinical entity and is associated with poor prognosis. Increased left ventricular (LV) afterload is one of the mechanisms contributing to low LV stroke volume index (SVi) in these patients. Aortic stiffness is an important determinant of LV afterload, but no previous study has evaluated its relationship with LVSVi in patients with AS. Methods Fifty-seven patients (mean age 66 ± 8 years, 71.9% men) with severe AS [aortic valve area (AVA) < 1.0 cm 2 ] undergoing aortic valve replacement (AVR) were included in this study. Echocardiographic parameters of AS were correlated with carotid-femoral pulse wave velocity (cfPWV), a measure of aortic stiffness, derived using PeriScope® device. Results Mean AVA was 0.63 ± 0.17 cm 2 with mean and peak transvalvular gradient 56.5 ± 18.8 mmHg and 83.2 ± 25.2 mmHg, respectively. Nearly half (26 of 57, 45.6%) of the subjects had SVi <35 mL/m 2 , indicative of low-flow severe AS. These subjects had lower AVA, lower aortic valve gradient, and LV ejection fraction. CfPWV was numerically lower in these subjects [median 1467 (interquartile range 978, 2259) vs 1588 (1106, 2167)] but the difference was not statistically significant ( p = 0.66). However, when analyzed as a continuous variable, cfPWV had significant positive correlation with SVi (Pearson's r 0.268, p = 0.048) and mean aortic valve gradient (Pearson's r 0.274, p = 0.043). Conclusions In patients with severe AS undergoing AVR, aortic stiffness measured using cfPWV is not a determinant of low-flow state. Instead, an increasing cfPWV tends to be associated with increasing transvalvular flow and gradient in these patients.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Aortic pulse wave velocity and its relationship with transaortic flow and gradients in patients with severe aortic stenosis undergoing aortic valve replacement

Ranjan

Grewal

Kasliwal

et al. 2020

Indian Heart Journal

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“…Another study compared the effects of both SAVR and TAVI on aortic stiffness and found that treatment of severe AoS by SAVR, but not with TAVI, was associated with an increase in aortic stiffness at 6 months 25. Conversely, other authors found no significant change in aortic stiffness after replacing the aortic valve in both SAVR and TAVI patients 12…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have investigated changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) as well as aortic stiffness after surgical aortic valve replacement (SAVR),9–12 and one study observed improvement of aortic distensibility 11. At present, there is little and conflicting information on the short-term aortic functional properties after transcatheter aortic valve implantation (TAVI) 12–14. The objective of this study was to assess the effect of TAVI on aortic stiffness and blood pressure levels shortly after TAVI.…”

Section: Introductionmentioning

confidence: 99%

<p>Short-term changes of blood pressure and aortic stiffness in older patients after transcatheter aortic valve implantation</p>

Goudzwaard¹,

Disegna²,

Ronde³

et al. 2019

CIA

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Background Both aortic valve stenosis and aortic stiffness are moderators of arterio ventricular coupling and independent predictors of cardiovascular morbidity and mortality. Studies on the effect of transcatheter aortic valve implantation (TAVI) on aortic functional properties are limited. We performed a study to investigate the possible short-term changes in aortic stiffness and other aortic functional properties after TAVI in older patients. Methods TAVI Care&Cure is an observational ongoing study including consecutive patients undergoing a TAVI procedure. Central and peripheral hemodynamic measurements were measured non invasively 1 day before (T-1) and 1 day after (T+1) TAVI using a validated oscillometric method using a brachial cuff (Mobil-O-Graph). Results 40 patients were included. Mean aortic valve area at baseline was 0.76±0.24 cm 2 . Indices of severity of aortic valve stenosis improved significantly. Systolic blood pressure (SBP) dropped by 8.5%, from 130.3±22.9 mmHg to 119.5±15.8 mmHg ( p =0.005). Diastolic blood pressure (DBP) dropped by 13.1% from 74.8±14.5 mmHg to 65.0±11.3 mmHg ( p <0.001). The arterial pulse wave velocity (aPWV) decreased from 12.05±1.99 m/s to 11.6±1.56 m/s ( p =0.006). Patients with high aPWV at baseline showed a significantly larger reduction in SBP in comparison to patients with low aPWV: – 20.3 mmHg (−14.1%) vs – 3.1 mmHg (−2.6%), respectively ( p =0.033). The same trend was found for the DBP: −16.2 (−20.4%) vs −4.5 mmHg (−6.3%) for high vs low aPWV at baseline ( p =0.037). Conclusion We found short-term changes in blood pressure and aortic stiffness after TAVI. The amplitude of the changes was the largest in patients with elevated aortic stiffness at baseline.

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Predictors of Success of Transcatheter Aortic Valve Implantation

Maloberti

Sirico

Buono

et al. 2019

Transcatheter Aortic Valve Implantation

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Arterial Stiffness in Aortic Stenosis: Relationship with Severity and Echocardiographic Procedures Response

Cited by 16 publications

References 24 publications

Aortic pulse wave velocity and its relationship with transaortic flow and gradients in patients with severe aortic stenosis undergoing aortic valve replacement

Aortic pulse wave velocity and its relationship with transaortic flow and gradients in patients with severe aortic stenosis undergoing aortic valve replacement

<p>Short-term changes of blood pressure and aortic stiffness in older patients after transcatheter aortic valve implantation</p>

Predictors of Success of Transcatheter Aortic Valve Implantation

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