Arterial Stiffness Changes in Severe Aortic Stenosis Patients Submitted to Valve Replacement Surgery

Autores da FMUP

• Francisca Almeida Saraiva

  Autor

• Rui João Gonçalves Cerqueira

  Autor

• António Sousa Barros

  Autor

• André Pedro Leite Martins Lourenço

  Autor

• Joaquim Adelino Correia Ferreira Leite Moreira

  Autor

Participantes de fora da FMUP

• Raimundo, R
• Moreira, R
• Moreira, S
• Ferreira, AF
• Amorim, MJ
• Pinho, P

Unidades de investigação

• Cirurgia e Fisiologia

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Background: Little is known about the impact of severe aortic stenosis (AS) in aortic stiffness and if there is any change after removing AS barrier with aortic valve replacement (AVR) surgery. Objective: To estimate carotid-femoral pulse wave velocity (PWV) changes after AVR surgery and to define PWV predictors in severe AS patients. Methods: Single-center retrospective cohort, including patients with severe AS who underwent AVR surgery with bioprostheses, between February 2017 and January 2019 and performed PWV measurements (Complior (R)) before and after the procedure (2 +/- 1 months). Before and after AVR, PWV values were compared through paired tests. The associations of PWV with clinical data were studied and linear regression models were applied to estimate pre and postoperative PWV independent predictors. The significance level was set at 5%. Results: We included 150 patients in the sample, with mean age of 72 +/- 8 years, and 51% being males. We found a statistically significant increase in PWV values after surgery (9.0 +/- 2.1 m/s vs. 9.9 +/- 2.2, p<0.001, before and after AVR, respectively) and an inverse association with AS severity variables. In the linear regression model, age and systolic blood pressure (SBP) were established as independent predictors of higher pre- and postoperative PWV, while higher mean valvular gradient emerged as a determinant of lower pre-AVR PWV. Conclusion: We documented an inverse correlation of arterial stiffness with the severity of AS in patients with AS, and a significant increase in PWV values after AVR surgery. Advanced age and higher SBP were associated with higher PWV values, although arterial function measurements were within the normal range.

Keywords

• Aortic Valve/surgery; Aortic Valve Stenosis/surgery; Aortic Valve; Replacement /methods; Pulse Wave Analysis