Arterial Stiffness in Aortic Stenosis: Relationship with Severity and Echocardiographic Procedures Response

High Blood Press Cardiovasc Prev. 2017 Mar;24(1):19-27. doi: 10.1007/s40292-016-0176-x. Epub 2017 Jan 11.

Abstract

Introduction: Aortic stenosis (AS) is more than only a degenerative disease, it could be also an atherosclerotic-like process involving the valve instead of the vessels. Little is known about the relation of arterial stiffness and AS.

Aim: We sought to determine wether pulse wave velocity (PWV), is related to AS severity and to the procedures response, both as surgical aortic-valve-replacement (AVR) and trascatheter-aortic-valve-implantation (TAVI).

Methods: 30 patients with severe AS were treated (15 AVR, 15 TAVI). Before the procedures (t0) and after 1 week (t1) echocardiography and PWV were evaluated.

Results: On the whole population, subjects with higher PWV showed higher transvalvular pressure gradient at baseline (mean: 56.5 ± 15.1 vs 45.4 ± 9.5; peak: 93.3 ± 26.4 vs 73.3 ± 14.9, p = 0.02) and, a significantly greater response to the procedures (mean: -42.9 ± 17.2 vs -27.9 ± 10.1, peak: -68.7 ± 29.2 vs -42.8 ± 16.4, p = 0.02). When the two different procedures groups were separated, data were confirmed only in the TAVI subgroup.

Conclusions: In patients undergoing procedures for AS, PWV is correlated with transvalvular gradient and, in TAVI subjects, is able to predict the echocardiographic response. Baseline evaluation of PWV in patients candidates to TAVI can help the selection of subjects, even if larger and longer studies are needed before definitive conclusion can be drawn.

Keywords: Aortic stenosis; Aortic valve replacement; Arterial stiffness; Pulse wave velocity; Transcatheter aortic valve implantation.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aorta / diagnostic imaging*
  • Aorta / physiopathology
  • Aortic Valve / diagnostic imaging*
  • Aortic Valve / physiopathology
  • Aortic Valve / surgery
  • Aortic Valve Stenosis / diagnostic imaging*
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / surgery
  • Echocardiography, Doppler*
  • Female
  • Hemodynamics*
  • Humans
  • Male
  • Patient Selection
  • Predictive Value of Tests
  • Pulse Wave Analysis*
  • Recovery of Function
  • Severity of Illness Index
  • Time Factors
  • Transcatheter Aortic Valve Replacement
  • Treatment Outcome
  • Vascular Stiffness*