&lt;p&gt;Short-term changes of blood pressure and aortic stiffness in older patients after transcatheter aortic valve implantation&lt;/p&gt;

Goudzwaard, Jeannette A.; Disegna, Eleonora; Ronde, Marjo de; Lenzen, Mattie J.; Jaegere, Peter P. de; Mattace-Raso, Francesco

doi:10.2147/cia.s211328

Cited by 6 publications

(7 citation statements)

References 28 publications

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“… Nemes et al 2007 10 12 SAVR, 58% male, mean age 65 ↓SBP ↓ 21, 180 and 365 ASi Gradual decreased ASi with time Vavuranakis et al 2012 11 30 TAVI, 47% male, mean age 80 ↑ MAP ⇔ SBP ⇔ 7–8 ASi No significant Δstiffness nor aortic distensibility Vizzardi et al 2014 12 15 TAVI, 40% male, mean age 83 ⇔ ↓ 180 and 365 ASi Sustained decreased stiffness after 12 months and increased distensibility Cantürk et al 2017 14 38 SAVR, 78% male, mean age 59 ⇔ ⇔ 90 PWV (MOG) Baseline PWV was associated with MPG and AVA. Goudzwaard et al 2019 15 40 TAVI, 58% male, mean age 80 ↓ ↓ 1 PWV and AIx with MOG ΔPWV was inversely correlated with baseline PWV Yotti et al 2015 18 23 TAVI, 63% male, mean age 79 ↑ SBP, DBP, MAP ↑ 0 Invasive AIx ↑ Vascular load after TAVI Pagolatou et al 2020 19 33 TAVI, 49% male, mean age 84 ↑ aortic BP ↓ AIx 1 Invasive AIx Müller et al 2018 20 50 TAVI,...…”

Section: Methods To Determine Arterial Stiffness In Aortic Valve Sten...mentioning

confidence: 99%

“…Two studies used this method of which one noted decreased oPWV 1 day after TAVI and another unchanged oPWV 90 days after SAVR. 14 , 15 However, concerns have been raised based on a study showing that 99.1% of the variation in oPWV was explained by age and systolic blood pressure. 16 Also, a considerable discrepancy between oPWV and cfPWV was observed in a Marfan cohort 17 indicating that oPWV may need validation in specific populations.…”

Section: Methods To Determine Arterial Stiffness In Aortic Valve Sten...mentioning

confidence: 99%

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Arterial Stiffness in Aortic Stenosis and the Impact of Aortic Valve Replacement

Plunde¹,

Bäck²

2022

VHRM

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The most common cause for interventional valve treatment is aortic stenosis. A cardinal symptom of aortic stenosis is heart failure due to the increased load exerted on the left ventricle. However, the left ventricular load is not solely determined based on the degree of aortic stenosis but is also impacted by arterial stiffness. The combined load can be determined by valvulo-arterial impedance (Zva), which is associated with poor outcome in aortic stenosis. We recently demonstrated low measures of systemic arterial stiffness in patients with aortic stenosis, and that arterial stiffness was increased after surgical aortic valve replacement. The results indicated a masked arterial stiffness in aortic stenosis when using methods incorporating peripheral arterial segments. Available studies using several different methods to assess arterial stiffness in relatively small aortic stenosis cohorts examined before and after either surgical or transcatheter aortic valve replacement/intervention have generated contradictory results. In this commentary, we present a detailed literature review to explore how different methods and measures of arterial stiffness in aortic stenosis capture or not, a masked arterial stiffness in aortic stenosis and possible reasons for the observed results. Future studies validating a non-invasive reproducible method to assess arterial stiffness in aortic stenosis patients could potentially lead to an implementation in pre-interventional risk assessment for aortic stenosis.

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Section: Methods To Determine Arterial Stiffness In Aortic Valve Sten...mentioning

confidence: 99%

Section: Methods To Determine Arterial Stiffness In Aortic Valve Sten...mentioning

confidence: 99%

Arterial Stiffness in Aortic Stenosis and the Impact of Aortic Valve Replacement

Plunde¹,

Bäck²

2022

VHRM

View full text Add to dashboard Cite

show abstract

“…As for those who experienced a reduction in PWV, this could be attributed to the impressive reduction of approximately 8.5 mmHg in MBP that was observed as well [24]. Also, results from the TAVI Care&Cure study in the Netherlands showed a reduction in aortic PWV 24h post-TAVI as assessed by Mobil-O-Graph, a finding in all probability driven principally by blood pressure reduction too [47].…”

Section: Aortic Stiffnessmentioning

confidence: 83%

“…In accordance with these acute findings, but also providing long-term results, we recently showed in a cohort of 90 patients undergoing TAVI that the arterial system exhibits an increase of stiffness as assessed by cfPWV and brachial-ankle PWV (baPWV) in response to the acute relief of the obstruction, which is retained in the long term after approximately 1 year of follow-up [35]. However, there are a few, smaller studies indicating no effect or even a decrease in stiffness after intervention [24,47]. These findings must be interpreted with caution; issues on sample size, as well as pressure dependency, might explain the discrepancy.…”

Section: Aortic Stiffnessmentioning

confidence: 99%

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Arterial biomarkers in the evaluation, management and prognosis of aortic stenosis

et al. 2021

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Degenerative aortic valve stenosis is the most common primary valve disease and a significant cause of cardiovascular morbidity and mortality. In an era when new techniques for the management of aortic stenosis are gaining ground, the understanding of this disease is more important than ever to optimize treatment. So far, the focus has been placed on the assessment of the valve itself. However, the role that the arterial system plays in the pathogenesis and natural history of the disease needs to be further elucidated. Arteriosclerosis, when it coexists with a stenotic valve, augments the load posed on the left ventricle contributing to greater impairment of cardiovascular function. Arterial stiffness, a well-established predictor for cardiovascular disease and all-cause mortality, could play a role in the prognosis and quality of life of this population. Several studies using a variety of indices to assess arterial stiffness have tried to address the potential utility of arterial function assessment in the case of aortic stenosis. Importantly, reliable data identify a prognostic role of arterial biomarkers in aortic stenosis and stress their possible use to optimize timing and method of treatment. This review aims at summarizing the existing knowledge on the interplay between the heart and the vessels in the presence of degenerative aortic stenosis, prior, upon and after interventional management. Further, it discusses the evidence supporting the potential clinical application of arterial biomarkers for the assessment of progression, severity, management and prognosis of aortic stenosis.

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Pulsatile energy consumption as a surrogate marker for vascular afterload improves with time post transcatheter aortic valve replacement in patients with aortic stenosis

et al. 2022

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The effect of arterial stiffening on elevated pulsatile left ventricular afterload patients with aortic stenosis (AS) is pronounced beyond systemic hypertension. Circulatory afterload pulsatile efficiency (CAPE) is a marker of vascular function, defined as the ratio of steady state energy consumption (SEC) to maintain systemic circulation and pulsatile energy consumption (PEC). Twenty patients aged 80 ± 7 years were assessed at baseline and a median of 60 days post transcatheter aortic valve replacement (TAVR), with pulsatile vascular load calculated using simultaneous radial applanation tonometry derived aortic pressure and cardiac magnetic resonance phase-contrast imaging derived ascending aortic flow. Eight out of 20 patients had a reduction in PEC post TAVR, and the reduction of PEC correlated strongly with the number of days post TAVR ( R = 0.62, P < 0.01). Patients assessed within the 100 days of TAVR had a rise in their PEC when compared to baseline (0.19 ± 0.09 vs 0.14 ± 0.08 W, P = 0.04). Baseline PEC correlated moderately with baseline SEC ( R = 0.49, P = 0.03), and a high baseline PEC was predictive of post TAVR PEC reduction ( R = 0.54, P =0.01). Overall, no significant differences were found between baseline and post TAVR for systolic aortic pressure (131 ± 20 vs 131 ± 20 mmHg), systemic vascular resistance (1894 ± 493 vs 2015 ± 519 dynes.s/cm 5 ), aortic valve ejection time (337 ± 22 vs 324 ± 34 ms) or aortic characteristic impedance (120 ± 48 vs 107 ± 41 dynes.s/cm 5 ). Improved flow profiles after TAVR likely unmask the true vascular properties by altering ventriculo-valvulo-arterial coupling, leading to downstream vascular remodelling secondary to flow conditioning, and results in eventual improvement of pulsatile afterload as reflected by our proposed index of CAPE.

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

Cited by 6 publications

References 28 publications

Arterial Stiffness in Aortic Stenosis and the Impact of Aortic Valve Replacement

Arterial Stiffness in Aortic Stenosis and the Impact of Aortic Valve Replacement

Arterial biomarkers in the evaluation, management and prognosis of aortic stenosis

Pulsatile energy consumption as a surrogate marker for vascular afterload improves with time post transcatheter aortic valve replacement in patients with aortic stenosis

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