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Ann Thorac Cardiovasc Surg. 2017 Oct 20;23(5):248-255. doi: 10.5761/atcs.oa.17-00062. Epub 2017 Sep 8.

Changes in Aortic Pulse Wave Velocity and the Predictors of Improvement in Arterial Stiffness Following Aortic Valve Replacement.

Author information

1
Department of Cardiovascular Surgery, Dragos Hospital, Bezm-i Alem University, Istanbul, Turkey.
2
Department of Cardiology, Istanbul Medipol University, Istanbul, Turkey.
3
Department of Cardiovascular Surgery, Okan University, Istanbul, Turkey.
4
Department of Cardiovascular Surgery, Istanbul Medipol University, Istanbul, Turkey.

Abstract

BACKGROUND:

The interaction between valvular aortic stenosis (AS) and arterial stiffness, as well as the impact of aortic valve replacement (AVR) on arterial stiffness, remains unclear. In this study, we aimed to evaluate the degree of AS severity on non-invasive pulse wave velocity (PWV) measurements. We also searched whether the AVR procedure favorably affects PWV.

METHODS:

In all, 38 patients undergoing AVR for chronic AS were included. The degree of aortic stiffness was measured with PWV at both baseline and 6 months after AVR. Improvement in aortic stiffness was defined as the absolute decrease in PWV at 6 months compared to the baseline value.

RESULTS:

The study population had a mean age of 59 ± 16 years, mean aortic gradient of 47.1 ± 6.4 mmHg, and mean aortic valve area (AVA) index of 0.45 ± 0.11 cm² /m² . Baseline PWV values correlated positively with the mean aortic gradient (r = 0.350, p = 0.031) and negatively with the AVA index (r = -0.512, p = 0.001). The mean PWV improved in 20 patients (53%) and worsened in 18 patients (47%). The baseline New York Heart Association (NYHA) class (odds ratio [OR] = 1.023, 95% confidence interval [CI] = 1.005-1.041, p = 0.041) and AVA index (OR = 1.040, 96% CI = 1.023-1.057, p = 0.028) emerged as the independent predictors of improvement in PWV following AVR.

CONCLUSION:

The severity of AS was significantly associated with baseline PWV. In general, the mean PWV did not change with AVR. Baseline NYHA class and the AVA index independently predicted PWV improvement following AVR. Since the change in PWV after AVR was polarized based on the patients' characteristics, such as preoperative NYHA functional class or AVA index, further studies are needed to confirm clinical significance of PWV change following AVR in severe AS patients.

KEYWORDS:

aortic stenosis; aortic stiffness; pulse wave velocity

PMID:
28890466
PMCID:
PMC5655337
DOI:
10.5761/atcs.oa.17-00062
[Indexed for MEDLINE]
Free PMC Article

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