Endovascular aortic repair significantly increased brachial-ankle pulse wave velocity from 1914 cm/s at baseline to 2096 cm/s at 1 week post-operation (p<0.05), indicating increased vascular stiffness.
Observational (n=40)
No
Does endovascular aortic repair (EVAR) alter vascular stiffness and cardiac structure/function in patients with aortic aneurysms?
EVAR increases arterial stiffness and induces left ventricular hypertrophy and diastolic dysfunction, which may contribute to impaired exercise tolerance post-procedure.
Absolute Event Rate: 2096% vs 1914%
p-value: p=<0.05
BACKGROUND: Endovascular aortic repair (EVAR) is performed in patients with thoracic or abdominal aortic aneurysm because it is less invasive than conventional open repair. However, the effects of EVAR on vascular and cardiac function remain to be clarified. METHODS AND RESULTS: We studied the effects of EVAR on several outcome variables in 40 consecutive patients undergoing EVAR for abdominal and/or thoracic aneurysm with preserved ejection fraction. Echocardiography and brachial-ankle pulse wave velocity (baPWV) data were collected before, 1 week, and 1 year after EVAR. Although no changes in blood pressure were found, baPWV, left ventricular mass index (LVMI), and left atrial volume index were significantly elevated at both post-op time periods after EVAR compared with baseline data. The changes in LVMI correlated with those in baPWV (R=0.32, P<0.05). Among the 22 patients who were successfully followed up, 13 showed deterioration in exercise tolerance 1 year after EVAR. Diastolic wall strain, an index for LV distensibility, was lower at baseline in patients with worsening exercise tolerance than in those with unchanged tolerance. CONCLUSIONS: EVAR increased vascular stiffness and induced LV hypertrophy and diastolic dysfunction without a corresponding elevation of blood pressure in the acute and chronic phases. In addition, low LV distensibility at baseline was associated with the impairment of exercise tolerance. EVAR-induced stiffness of arteries leads to limited clinical symptoms.
Takeda et al. (Fri,) conducted a observational in Thoracic or abdominal aortic aneurysm (n=40). Endovascular aortic repair (EVAR) vs. Baseline (pre-operative) was evaluated on Brachial-ankle pulse wave velocity (baPWV) at 1 week post-operation (p=<0.05). Endovascular aortic repair significantly increased brachial-ankle pulse wave velocity from 1914 cm/s at baseline to 2096 cm/s at 1 week post-operation (p<0.05), indicating increased vascular stiffness.