Endovascular aortic repair impact on myocardial contractility: A prospective study

Abstract

BackgroundThis study aimed to estimate if the altered sphygmic wave transmission may affect the left ventricular (LV) contractile function in patients undergoing endovascular aortic repair (EVAR).MethodsA prospective single‐centre study was carried out on consecutive patients undergoing EVAR for abdominal aortic aneurysm. A preoperative and 6‐month single photon emission computed tomography (SPECT) with arterial stiffness measurement were performed to evaluate variations in pressure wave curve and myocardial perfusion parameters.ResultsFrom 2018 to 2020 a total of 16 patients were included in the study. Among the parameters evaluated, we found a measurable reduction of the reflected wave transit time from pre‐ to postoperative period, for both stress (115.13 ± 7.2 ms–111.1 ± 7.0 ms, p = .08) and rest SPECT acquisitions (115.3 ± 6.2 ms–112.2 ± 5.6 ms, p = .1). Unidirectional increase of both LV end‐systolic volume (34 ± 9 mL–39 ± 8 mL, p = .02) and end‐diastolic volume (85 ± 34 mL–89 ± 29 mL, p = .6) was also observed. Lastly, the ratio between the end‐systolic pressure and the end‐systolic volume (maximal systolic myocardial stiffness) decreased from 3.6 ± 1.5 mmHg/mL to 2.66 ± .74 mmHg/mL (p = .03).ConclusionsOur data showed that EVAR induced an altered transmission of the sphygmic wave associated with an early LV contractile impairment.