Abstract
Objective: Ventriculo-arterial (VA) coupling characterizes the interaction between myocardial contractile function and the load opposed by the arterial circulation. Clinically, measurable indicators allowing for non-invasive cardiovascular performance assessment include pulse wave velocity (PWV), left ventricular (GLS) and left atrial strain (LA strain). Endovascular repair of the aortic aneurysm is related with changes in arterial properties, yet the impact of these changes on left ventricular and atrial function remains unclear. Aim: This study aimed to compare selected parameters of cardiovascular performance between individuals post-endovascular abdominal aortic aneurysm repair and age- and sex-matched group of hypertensive individuals without aortic aneurysm. Design and method: The study group comprised 36 patients who underwent endovascular stent grafting of the abdominal aorta (mean time from surgery 21,8±8,9 months). Control group included 43 hypertensives matched for age, sex and BMI. In all subjects structured echocardiographic examination was performed, including evaluation of LA strain, left ventricular ejection fraction (EF) and GLS. Carotid-femoral PWV using SphygmoCor device was measured in all participants. Statistical analysis was conducted using SPSS statistics software. Results: The study and control groups did not differ in age (68,9±8,7 vs 67,6±6,6 years; p >0.05), sex (M/F: 32/4 vs 38/5; p>0.05) or BMI (28,9±4,9 vs 29,7 kg/m2; p>;0.05). The study group exhibited significantly higher PWV compared to controls (10,02±1,98 vs 8.99±1,08 m/s; p<0.05). Furthermore, in the study group lower left ventricular ejection fraction (54,7±9,2 vs 59,0± 5,72%; p<0,01), lower absolute values of LV GLS (16,3±2,5 vs 19,0±3,2%, p=0,05) and lower LA strain (23,5±6,2 vs 29,5±10,8%; p<0.01) were observed. Conclusions: This pilot study suggests that changes in arterial stiffness related to endovascular aortic aneurysm repair are associated with worse left ventricular systolic function and left atrial performance. Elucidating their etiology and dynamics necessitates further investigation through prospective studies that account for confounding factors, such as other risk factors that may influence the outcomes of the assessed parameters.
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