- Oral presentation
- Open Access
Arterial stiffness in severe aortic stenosis following Transcatheter Aortic Valve Implantation (TAVI) compared to Surgical Aortic Valve Replacement (SAVR)
© Musa et al.; licensee BioMed Central Ltd. 2014
- Published: 16 January 2014
- Pulse Wave Velocity
- Transcatheter Aortic Valve Implantation
- Steady State Free Precession
- Severe Aortic Stenosis
- Aortic Distensibility
Arterial stiffness is an independent predictor of cardiovascular mortality and can be assessed by CMR measurement of aortic distensibility (AD) and pulse wave velocity (PWV). We sought to determine AD and PWV in patients with severe symptomatic aortic stenosis and identify changes following TAVI compared to SAVR.
27 SAVR patients (age 71.8 ± 7.0 years, 75% male, EuroSCORE II 1.43 ± 0.44%) and 21 TAVI patients (age 81.7 ± 6.3 years, 52% male, EuroSCORE II 6.32 ± 5.99%) were studied before and 6 months following valve replacement. Arterial pulse pressure significantly increased following SAVR (57 ± 19.6 vs. 63 ± 14.6 mmHg, p < 0.05) but not after TAVI (68 ± 24.0 vs. 67 ± 21.6 mmHg, p = 0.91). AD significantly decreased post SAVR (2.00 ± 1.57 vs. 1.39 ± 0.69 × 10-3 mmHg-1, p < 0.05) whereas there was no change observed in the TAVI group (1.68 ± 0.80 vs. 1.76 ± 0.85 × 10-3 mmHg-1, p = 0.74). PWV significantly increased post-SAVR (6.69 ± 5.12 vs. 12.13 ± 6.22 ms-1, p = 0.01) whereas there was no change observed in the TAVI group (9.91 ± 9.32 vs. 12.42 ± 9.24 ms-1, p = 0.23).
In patients with severe aortic stenosis, SAVR but not TAVI is associated with a significant increase in PWV and decrease in AD at 6 months. This increase in aortic stiffness may be a consequence of the different techniques of valve replacement and has potential long-term implications on cardiovascular mortality.
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