Artery Research (Dec 2017)

P170 SHORT-TERM EFFECTS OF TRANSCATHETER AORTIC VALVE IMPLANTATION ON AORTIC FUNCTION AND HEMODYNAMICS

  • Dimitrios Terentes-Printzios,
  • Charalambos Vlachopoulos,
  • Konstantinos Toutouzas,
  • Georgios Latsios,
  • Andreas Synetos,
  • Georgios Trantalis,
  • Fani Mitropoulou,
  • Maria Drakopoulou,
  • Konstantinos Stathogiannis,
  • Vicky Penesopoulou,
  • Konstantinos Kalogeras,
  • Konstantinos Aznaouridis,
  • Manolis Vavuranakis,
  • Dimitrios Tousoulis

DOI
https://doi.org/10.1016/j.artres.2017.10.118
Journal volume & issue
Vol. 20

Abstract

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Purpose/Background/Objectives: Aortic stiffness and hemodynamics are independent predictors of adverse cardiovascular events. Transcatheter aortic valve implantation (TAVI) is growingly used in elderly patients with aortic stenosis. We sought to investigate the effect of TAVI upon aortic vascular function and hemodynamics as well as the interplay between genders. Methods: Twenty high-risk patients (mean age 82.2±5.3 years, 13 female) with severe symptomatic aortic stenosis undergoing TAVI were included. Aortic stiffness was estimated through carotid-femoral pulse wave velocity (PWV). Aortic hemodynamics (aortic pressures, aortic augmentation index [AIx]) and subendocardial viability ratio (SEVR) were measured with Sphygmocor. Measurements were conducted prior to the implantation and at discharge. Results: PWV prior to the implantation was 8.6±1.5 m/s and aortic AIx = 33.0±14.0% for the overall population. There was no statistically significant change in peripheral or aortic pressures as well as on aortic stiffness after implantation of TAVI. However, there was a marginally non-significant trend for an increase in SEVR (116±28 vs 131±40%, p = 0.067). Results to the male population were similar to the overall population. Conversely, in the female population, there was a significant increase in PWV after TAVI (8.4±1.2 m/s vs 8.9±1.3% with p = 0.034, respectively). Furthermore, there was a significant increase in SEVR after TAVI (107±28 vs 125±24% with p = 0.002, respectively). All other variables did not change significantly in the female population. Conclusion: Our study shows that shortly after TAVI female subjects experience an increase in aortic stiffness with an improvement of myocardial perfusion. These findings further elucidate the short-term hemodynamic consequences of aortic valve repair.