Abstract
BackgroundPatients with degenerative aortic stenosis (AS) are often older and have systemic hypertension and atherosclerosis, which all lead to increased aortic stiffness. We aimed to assess the determinants of carotid-femoral pulse wave velocity (cf-PWV), a direct measure of aortic stiffness, and its association with revealed symptoms and clinical outcome in patients with AS. MethodsWe included 103 asymptomatic patients aged 66.6 ± 13.2 years (range 27–85 years, 69% males) with moderate (n = 50) and severe (n = 53) AS. All underwent a comprehensive echocardiography, exercise treadmill test (ETT) and assessment of aortic stiffness derived from cf-PWV by applanation tonometry. ResultsThe mean cf-PWV was 10.6 ± 3.1 m/s and resting brachial blood pressure (BP) 139 ± 20/79 ± 11 mmHg. Increased cf-PWV (≥10 m/s) was found in 44% (n = 45) patients. Patients with moderate and severe AS had a similar degree of aortic stiffness (cf-PWV 10.7 ± 3.3 vs. 10.5 ± 3.0 m/s, p = 0.698). In a univariate logistic regression analysis, higher cf-PWV was not associated with revealed symptoms (odds ratio [OR] for 1SD higher cf-PWV 1.12; 95% CI 0.62–2.04, p = 0.706). In a multivariable linear regression analysis, age, resting brachial systolic BP and diabetes were associated with higher cf-PWV independent of antihypertensive treatment and left ventricular ejection fraction. The event-free survival was significantly lower in patients with cf-PWV ≥10 m/s compared to those with cf-PWV <10 m/s (p = 0.015). ConclusionIncreased cf-PWV was common in patients with moderate or severe AS, and was associated with higher cardiovascular disease burden and impaired prognosis. cf-PWV did not correlate with the severity of AS or the frequencies of revealed symptoms by ETT.
Highlights
Human arteries inevitably become gradually stiffer with age, a process referred to as arterial sclerosis [1,2]
The study consisted of transthoracic echocardiography, a treadmill exercise test and measurement of aortic stiffness derived from carotidfemoral pulse wave velocity (cf-PWV) by an applanation tonometry [15]
Little is known about aortic stiffness derived from cf-PWV in aortic stenosis (AS) patients, and its association with exercise treadmill test (ETT) measures
Summary
Human arteries inevitably become gradually stiffer with age, a process referred to as arterial sclerosis [1,2]. The capacitance function of the aorta is diminished, forward pressure pulse waves propagate more rapidly, and reflected pulse waves return more quickly and with a higher amplitude to the proximal aorta. This in turns contributes to systolic hypertension and widening of the pulse pressure (PP) [6,7,8]. In a multivariable linear regression analysis, age, resting brachial systolic BP and diabetes were associated with higher cf-PWV independent of antihypertensive treatment and left ventricular ejection fraction. Conclusion: Increased cf-PWV was common in patients with moderate or severe AS, and was associated with higher cardiovascular disease burden and impaired prognosis. Conclusion: Increased cf-PWV was common in patients with moderate or severe AS, and was associated with higher cardiovascular disease burden and impaired prognosis. cf-PWV did not correlate with the severity of AS or the frequencies of revealed symptoms by ETT
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
