Validation of Central Pressure Estimation in Patients with an Aortic Aneurysm Before and After Endovascular Repair

Holewijn, Suzanne; Vermeulen, Jenske J.M.; Helvert, Majorie van; Velde, Lennart van de; Reijnen, Michel M.P.J.

doi:10.1007/s13239-021-00574-3

Cited by 2 publications

(1 citation statement)

References 38 publications

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“…The central aortic pressure (CAP) is an index of aortic stiffness, which was originally determined by complex and invasive aortic measurements [15]. The carotid pressure measured using carotid artery tonometry is an alternative valid, non-invasive, interchangeable method of CAP measurement, which is usually obtained transcutaneously at the right common carotid artery [16], while non-invasive central pressure estimations are accurate in patients with an abdominal aortic aneurysm, before and after endovascular repair [17]. O'Rourke et al, in their arterial waveform analysis, supported that the arterial pressure waveform is a composite of a forward-traveling wave, generated by left ventricular ejection, and a backward-traveling reflected wave arising from sites of impedance mismatch.…”

Section: Central Aortic Pressure (Cap) and Augmentation Index (Aix)mentioning

confidence: 99%

Study Protocol of a Prospective, Monocentric, Single-Arm Study Investigating the Correlation of Endograft Properties with Aortic Stiffness in Abdominal Aortic Aneurysm Patients Subjected to Endovascular Aortic Repair

Abatzis-Papadopoulos,

Tigkiropoulos,

Nikas

et al. 2024

JCM

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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.

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Section: Central Aortic Pressure (Cap) and Augmentation Index (Aix)mentioning

confidence: 99%

Study Protocol of a Prospective, Monocentric, Single-Arm Study Investigating the Correlation of Endograft Properties with Aortic Stiffness in Abdominal Aortic Aneurysm Patients Subjected to Endovascular Aortic Repair

Abatzis-Papadopoulos,

Tigkiropoulos,

Nikas

et al. 2024

JCM

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Changes of vascular stiffness and central blood pressure after endovascular aneurysm repair in patients with hypertension. Results of one-year follow-up

Gurevich,

Emelyanov,

Ionov

et al. 2023

Russ J Cardiol

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Aim. To assess the changes of arterial stiffness, central blood pressure (CBP), and determine the factors potentially influencing them in patients with descending thoracic and abdominal aortic aneurysm, in combination with hypertension, one year after endovascular aneurysm repair ((T)EVAR).Material and methods. Patients ≥18 years of age without clinically significant cardiac arrhythmias were included. Before surgery and a year later, we determined peripheral blood pressure, heart rate (HR), CBP, augmentation index (AIx), pressure at the point of maximum rise of the direct pulse wave (PT1h), time to return of the reflected pressure wave (Tr) and carotid femoral pulse wave velocity (cfPWV).Results. Fifty patients were included (mean age, 68±9 years; 41 men; 16 with descending thoracic aortic aneurysm, 34 with abdominal aortic aneurysm), 23 patients were reexamined. After (T)EVAR, an increase in cfPWV (+2,6 m/s, p<0,001), PT1h (+5 mm Hg, p=0,026), peripheral pulse pressure (+7 mm Hg, p=0,039), heart rate (+5 beats/min, p=0,025). The CBP and AIx values have not changed. The dependence of Tr decrease on the stent-graft length (β=0,42) and the decrease in heart rate (β=-0,52) was found. During the year, 6 cardiovascular events were registered.Conclusion. Graft implantation is accompanied by an increase in cfPWV, regardless of aneurysm location. An increase in PT1h one year after (T)EVAR may reflect a decrease in aortic distensibility and worsening damping function. No changes of CBP and AIx is probably explained by reflected wave characteristics after surgery. Predictors of Tr are — increase in heart rate and implantation of longer stent grafts.

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Validation of Central Pressure Estimation in Patients with an Aortic Aneurysm Before and After Endovascular Repair

Cited by 2 publications

References 38 publications

Study Protocol of a Prospective, Monocentric, Single-Arm Study Investigating the Correlation of Endograft Properties with Aortic Stiffness in Abdominal Aortic Aneurysm Patients Subjected to Endovascular Aortic Repair

Study Protocol of a Prospective, Monocentric, Single-Arm Study Investigating the Correlation of Endograft Properties with Aortic Stiffness in Abdominal Aortic Aneurysm Patients Subjected to Endovascular Aortic Repair

Changes of vascular stiffness and central blood pressure after endovascular aneurysm repair in patients with hypertension. Results of one-year follow-up

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