Abstract
Reflected wave increases after endovascular aortic repair (EVAR) in patients with aortic aneurysm. This affects the left ventricular (LV) diastolic function and leads to a poor prognosis. This study aimed to evaluate the relationship between increased reflected wave amplitude and aortic diameter after EVAR. EVAR was performed in seven healthy goats. We assessed wave intensity (WI), aortic diameter, and stiffness parameter β. Moreover, we evaluated the relationship between negative reflected wave (NW, reflected waves toward the heart from the periphery by WI) and other parameters after EVAR. Results showed an increase in stiffness parameter β (3.5 ± 0.3 vs 15.9 ± 4.7, p = 0.018) and a decrease in the change of aortic diameter (6.9 ± 0.7 vs 2.7 ± 0.4%, p = 0.018) after EVAR. The NW was significantly amplified after EVAR from baseline (−589.8 ± 143.4 to − 1192.3 ± 303.7 mmHg-m/sec3, p = 0.043). The NW showed a significant correlation with maximum aortic diameter (R = 0.707, p = 0.038) and minimum aortic diameter (R = 0.724, p = 0.033). The reflected wave was enhanced after EVAR and was correlated to the aortic diameter at the stent-graft site. It is important to consider that patients with smaller aortic diameters in landing zone who undergo EVAR may develop LV dysfunction.
Highlights
Reflected wave increases after endovascular aortic repair (EVAR) in patients with aortic aneurysm
There were no significant differences between baseline and after EVAR in forward pressure (Pf) and backward pressure (Pb), reflection magnitude (RM) and reflection index (RI)
Our major findings were as follows (1) Negative wave intensity, which is indicated by backward waves reflected toward the heart from the periphery, was significantly enhanced after EVAR compared to that at baseline; and (2) Negative wave intensity correlated with the aortic diameters at stent-graft site
Summary
Reflected wave increases after endovascular aortic repair (EVAR) in patients with aortic aneurysm. This affects the left ventricular (LV) diastolic function and leads to a poor prognosis. Results showed an increase in stiffness parameter β (3.5 ± 0.3 vs 15.9 ± 4.7, p = 0.018) and a decrease in the change of aortic diameter (6.9 ± 0.7 vs 2.7 ± 0.4%, p = 0.018) after EVAR. The reflected wave was enhanced after EVAR and was correlated to the aortic diameter at the stent-graft site. PWV correlates with vascular d iameter[9,10], and an increased PWV leads to an early reflected w ave[7,11] It remains unclear whether the aortic diameter, where the stent-graft is deployed, is related to the enhancement of the reflected wave after EVAR
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