Aortic Valve Replacement/methods

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Editorial

Arterial Stiffness in Aortic Stenosis

The paper “Arterial Stiffness Changes in Severe Aortic Stenosis Patients Submitted to Valve Replacement Surgery” has important information on the behavior of arterial stiffness before and after aortic valve replacement.

They studied 150 patients with severe aortic stenosis submitted to aortic valve replacement with bioprosthesis. They used a noninvasive method, carotid-femoral pressure wave velocity (PWV) measured through Complior Analyse, to study arterial stiffness. Other methods could have been used, such as invasive pressure catheter measurements, MRI and peripheral cuff sensors, but PWV is the gold standard.

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Original Article

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

Renata Raimundo et al. Francisca Saraiva Raquel Moreira Soraia Moreira … Ana Filipa Ferreira Rui J. Cerqueira Mario Jorge Amorim Paulo Pinho António Sousa Barros André P. Lourenço Adelino Leite-Moreira

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®) 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. (Arq Bras Cardiol. 2021; 116(3):475-482)