Arterial Stiffness and Aortic Aneurysmal Disease – A Narrative Review
Konstantinos Moulakakis,
Christos Pitros,
Ioannis Theodosopoulos
et al.
Abstract:It has been documented that large-artery stiffness is independently associated with increased cardiovascular risk and may potentially lead to heart and kidney failure and cerebrovascular disease. A systematic review of studies investigating changes in arterial stiffness in patients undergoing endovascular repair of aortic disease was conducted. In addition, a review of the available literature was performed, analyzing findings from studies using the cardio-ankle vascular index (CAVI) as a marker of arterial st… Show more
“…This increase in PWV has been attributed to the increase in aortic rigidity that the implantation of aortic endoprostheses causes [6]. Similarly, Moulakakis et al, in their narrative review, support that the treatment of an AAA with EVAR reduces aortic compliance significantly, and an increase in arterial stiffness was uniformly observed in studies investigating patients following TEVAR, and the effect was more pronounced in young patients [24].Apart from a decrease in aortic compliance and an increase in aortic stiffness, EVAR has been related to reduced cardiac systolic function, heart diastolic dysfunction, and left ventricle hypertrophy [25,26]. Studies mention the possible harmful effect of EVAR not only on heart functions but also on other vascular beds, including kidney function [25][26][27].…”
The number of endovascular aortic repairs (EVARs) has surpassed the number of open surgical repairs of abdominal aortic aneurysms (AAAs) worldwide. The available commercial endoprostheses are composed of materials that are stiffer than the native aortic wall. As a consequence, the implantation of stent–graft endoprostheses during EVAR increases aortic rigidity and thus aortic stiffness, resulting in a decrease in abdominal aorta compliance. EVAR has been found to have a possibly harmful effect not only on heart functions but also on other vascular beds, including kidney function, due to the decrease in aortic compliance that it causes. Aortic stiffness is measured by various hemodynamic indices like the pulse wave velocity (PWV), the central aortic pressure (CAP), and the augmentation index (AIx). In the literature, there are increasing numbers of studies investigating the properties of endografts, which are strongly related to increases in aortic stiffness. However, there is a lack of data on whether there is a correlation between the length of various endografts implanted during EVAR and the increase in the PWV, CAP, and AIx postoperatively compared to the preoperative values. The aim of this prospective, observational, monocentric, single-arm study is to investigate the correlation between endograft length and the postoperative increase in the PWV, CAP, and AIx in patients subjected to EVAR. Additionally, this study intends to identify other endograft properties related to increases in the PWV, CAP, and AIx. Other endpoints to be studied are the existence of immediate postoperative myocardial and kidney injury after EVAR. The prediction of cardiovascular events caused by endograft-related increased aortic stiffness could contribute to the improvement of various endograft properties so that the impact of endografts on the native aortic wall can be minimized.
“…This increase in PWV has been attributed to the increase in aortic rigidity that the implantation of aortic endoprostheses causes [6]. Similarly, Moulakakis et al, in their narrative review, support that the treatment of an AAA with EVAR reduces aortic compliance significantly, and an increase in arterial stiffness was uniformly observed in studies investigating patients following TEVAR, and the effect was more pronounced in young patients [24].Apart from a decrease in aortic compliance and an increase in aortic stiffness, EVAR has been related to reduced cardiac systolic function, heart diastolic dysfunction, and left ventricle hypertrophy [25,26]. Studies mention the possible harmful effect of EVAR not only on heart functions but also on other vascular beds, including kidney function [25][26][27].…”
The number of endovascular aortic repairs (EVARs) has surpassed the number of open surgical repairs of abdominal aortic aneurysms (AAAs) worldwide. The available commercial endoprostheses are composed of materials that are stiffer than the native aortic wall. As a consequence, the implantation of stent–graft endoprostheses during EVAR increases aortic rigidity and thus aortic stiffness, resulting in a decrease in abdominal aorta compliance. EVAR has been found to have a possibly harmful effect not only on heart functions but also on other vascular beds, including kidney function, due to the decrease in aortic compliance that it causes. Aortic stiffness is measured by various hemodynamic indices like the pulse wave velocity (PWV), the central aortic pressure (CAP), and the augmentation index (AIx). In the literature, there are increasing numbers of studies investigating the properties of endografts, which are strongly related to increases in aortic stiffness. However, there is a lack of data on whether there is a correlation between the length of various endografts implanted during EVAR and the increase in the PWV, CAP, and AIx postoperatively compared to the preoperative values. The aim of this prospective, observational, monocentric, single-arm study is to investigate the correlation between endograft length and the postoperative increase in the PWV, CAP, and AIx in patients subjected to EVAR. Additionally, this study intends to identify other endograft properties related to increases in the PWV, CAP, and AIx. Other endpoints to be studied are the existence of immediate postoperative myocardial and kidney injury after EVAR. The prediction of cardiovascular events caused by endograft-related increased aortic stiffness could contribute to the improvement of various endograft properties so that the impact of endografts on the native aortic wall can be minimized.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.