4.7 THE EFFECT OF TRANSCATHETER AORTIC VALVE IMPLANTATION ON AORTIC STIFFNESS AND HEMODYNAMICS

Abstract

Purpose/Background/Objectives: Aortic stiffness and central hemodynamics are established vascular biomarkers. Transcatheter aortic valve implantation (TAVI) is a promising new technique for the treatment of aortic valve stenosis in elderly patients. We examined the effect of TAVI on the elastic properties of the aorta and on central hemodynamics. Methods: We included fifty patients (mean age 80.7 ± 8.3 years, 27 male) with symptomatic aortic stenosis treated by TAVI. In measurements prior and acutely after the procedure, carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle pulse wave velocity (baPWV) were used as indicators of arterial stiffness. Aortic pressures and aortic augmentation index corrected for heart rate [AIx@75] were used to assess aortic hemodynamics. Results: There was a statistically significant increase in measurements of arterial stiffness (7.7 ± 1.5 vs 8.3 ± 1.9 m/s for cfPWV and 1931 ± 577 vs. 2469 ± 682 cm/s with p = 0.006 and p0.05). Peripheral pulse pressure (p = 0.047) increased significantly and peripheral DBP (p = 0.05) decreased significantly. Conclusions: Our study led to the observation that patients undergoing TAVI present with an increase in arterial stiffness in the acute phase after the procedure, accompanied by an improvement of wave reflections. At the same time, a dissociation between aortic and peripheral BP after TAVI was observed, which may indicate important clinical value.