Estimated Pulse Wave Velocity as a Marker of Blood-Pressure-Dependent Arterial Load and Ventricular–Vascular Interaction in Severe Aortic Stenosis Before and After Transcatheter Aortic Valve Replacement

Q: What are the key findings of this study?

TAVR significantly reduced estimated pulse wave velocity from 12.79 ± 1.54 to 12.39 ± 1.57 m/s (MD -0.40 m/s, p = 0.0001) at hospital discharge in elderly patients with severe aortic stenosis.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Severe aortic stenosis (n=100). Intervention: Transcatheter aortic valve replacement (TAVR) vs. Pre-procedural baseline (pre- vs. post-TAVR comparison). Primary outcome: Change in estimated pulse wave velocity (ePWV) after TAVR (MD -0.40 m/s, p=0.0001).

Q: What does this research mean for the field?

Transcatheter aortic valve replacement (TAVR) produces an early reduction in estimated pulse wave velocity (ePWV) alongside modest improvements in left ventricular ejection fraction in elderly patients with severe aortic stenosis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Simina Mariana Moroz; A Negru; Mirela Baba; Silvia Luca; Mihaela Valcovici; Alina Maria Lupu; Darius G. Buriman; Daniel-Dumitru Nișulescu; Ana Lascu; D Lighezan; Ioana Mozos

doi:10.3390/jcdd13040149

March 25, 2026Journal of Cardiovascular Development and DiseaseOpen Access

Estimated Pulse Wave Velocity as a Marker of Blood-Pressure-Dependent Arterial Load and Ventricular–Vascular Interaction in Severe Aortic Stenosis Before and After Transcatheter Aortic Valve Replacement

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Key result

TAVR is linked to a ~0.4 m/s reduction in estimated pulse wave velocity at discharge.

MD -0.40 m/s
P=0.0001
n=100

Figures

Why the study?

The immediate effects of transcatheter aortic valve replacement on blood-pressure-dependent arterial load and ventricular-vascular interactions are not fully clarified.

Does transcatheter aortic valve replacement (TAVR) reduce blood pressure-dependent arterial load (measured by estimated pulse wave velocity) and alter ventricular–vascular and inflammatory interactions in elderly patients with severe aortic stenosis at hospital discharge?

Key Points

To assess changes in estimated pulse wave velocity (ePWV) before and after transcatheter aortic valve replacement (TAVR) and evaluate its relationship with ventricular function and inflammatory biomarkers.
Conducted a retrospective observational study of 100 elderly patients (aged 78 ± 5.83 years, 52% male) with severe aortic stenosis undergoing TAVR.
Calculated ePWV from age and mean arterial pressure, and assessed left ventricular geometry, systolic function, and hemodynamics via echocardiography before TAVR and at discharge (median 8 days post-procedure).
TAVR significantly reduced ePWV from 12.79 ± 1.54 m/s to 12.39 ± 1.54 m/s (p < 0.01; full text notes 12.39 ± 1.57 m/s, p = 0.0001) alongside a mean systolic blood pressure decrease of −7 mmHg.
Left ventricular ejection fraction improved significantly from 44.89 ± 9.2% to 46.7 ± 7.95% (p < 0.01; p = 0.0004 in full text) while transvalvular mean gradient dropped from 49.94 ± 15.16 mmHg to 10.29 ± 5.07 mmHg (p < 0.0001).
Baseline ePWV independently correlated with adverse left ventricular remodeling, while post-procedural ePWV shifted to associate with right ventricular indices, and pre-existing correlations with inflammatory markers vanished after TAVR.

Study Design

Type

Cohort (n=100)

Multicenter

No

Structured PICO

Does transcatheter aortic valve replacement (TAVR) reduce blood pressure-dependent arterial load (measured by estimated pulse wave velocity) and alter ventricular–vascular and inflammatory interactions in elderly patients with severe aortic stenosis at hospital discharge?

P

Population

100 elderly patients (mean age 78 years, 48% female) with symptomatic severe aortic stenosis (AVA ≤1.0 cm²) undergoing TAVR in Romania, reassessed at hospital discharge (median 8 days).

E

Exposure

Transcatheter aortic valve replacement (TAVR) (Medtronic valves used in 74% of cases), with pre- and post-procedural assessment of blood pressure-dependent arterial load via estimated pulse wave velocity (ePWV), standard echocardiography, and venous blood biomarkers.

O

Outcome

Change in estimated pulse wave velocity (ePWV, derived from age and mean arterial pressure) from pre-intervention baseline to hospital discharge (median 8 days after TAVR).surrogate

Main Result

Mean Difference: -0.4

Absolute Event Rate: 12.39% vs 12.79%

p-value: p=0.0001

Limitations

Retrospective, single-center design limiting causal inference and generalizability
Arterial stiffness was assessed using estimated rather than directly measured pulse wave velocity, which is mathematically dependent on blood pressure
Short-term follow-up at hospital discharge (8 days) without long-term prognostic data
Lack of formal correction for multiple comparisons across correlation and regression analyses
Absence of specific inflammatory mediators (such as CRP or interleukins) and stroke volume index data
Potential confounding from minor undocumented adjustments in antihypertensive or diuretic medications during hospitalization
Retrospective single-center design limits causal inference and generalizability
Reliance on calculated ePWV (derived from age and mean arterial pressure) rather than directly measured carotid-femoral pulse wave velocity
Short follow-up limited to hospital discharge (8 days post-TAVR) without long-term clinical outcomes
No formal statistical correction for multiple comparisons across exploratory correlation and regression analyses
Non-specific inflammatory biomarkers used; C-reactive protein, interleukins, and stroke volume index were unavailable
Potential confounding from undocumented in-hospital adjustments to antihypertensive (18% had medication adjustments) or diuretic therapy

Implication

In elderly patients with severe aortic stenosis, TAVR produces a modest early reduction in estimated pulse wave velocity at discharge that reflects acute blood pressure-dependent hemodynamic unloading and shifting ventricular–vascular interactions from the left to the right ventricle rather than immediate structural arterial remodeling.

Abstract

Background: Severe aortic stenosis (AS) increases left ventricular afterload and disrupts ventricular–vascular coupling. Transcatheter aortic valve replacement (TAVR) promptly relieves valvular obstruction, but its immediate effects on blood pressure-dependent arterial load and ventricular–vascular interactions are not fully clarified. Estimated pulse wave velocity (ePWV), derived from age and mean arterial pressure, is a convenient surrogate of global arterial load. The study aimed to assess ePWV before and after TAVR and its relationship with ventricular function and inflammatory biomarkers. Methods: In this retrospective observational study, 100 elderly patients with severe AS undergoing TAVR underwent detailed clinical, laboratory, and echocardiographic assessments before and after the procedure. Arterial stiffness was quantified using ePWV, while left ventricular geometry and systolic function were evaluated by standard echocardiography. Post-procedural reassessment was performed at hospital discharge (median 8 days after TAVR). Results: TAVR led to a modest but significant reduction in ePWV (from 12.79 ± 1.54 to 12.39 ± 1.54 m/s, p < 0.01) and improvement in left ventricular ejection fraction (LVEF) (from 44.89 ± 9.2% to 46.7 ± 7.95%, p < 0.01). Higher baseline ePWV correlated with unfavorable left ventricular remodeling and systolic dysfunction, and post-procedural ePWV remained linked to right ventricular performance. Before TAVR, ePWV and LVEF were both associated with inflammatory biomarkers, relationships that disappeared after intervention. Conclusions: Overall, ePWV functioned as an integrated measure of ventricular–vascular interaction and global hemodynamic load, though its interpretation post-TAVR requires caution due to direct blood pressure dependence and confounding by acute procedural inflammation.

Discussion

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Cite This Study

Moroz et al. (2026) conducted a cohort in Severe aortic stenosis (n=100). Transcatheter aortic valve replacement (TAVR) vs. Pre-procedural baseline (pre- vs. post-TAVR comparison) was evaluated on Change in estimated pulse wave velocity (ePWV) after TAVR (MD -0.40 m/s, p=0.0001). TAVR significantly reduced estimated pulse wave velocity from 12.79 ± 1.54 to 12.39 ± 1.57 m/s (MD -0.40 m/s, p = 0.0001) at hospital discharge in elderly patients with severe aortic stenosis.

synapsesocial.com/papers/69c6201515a0a509bde18768 https://doi.org/10.3390/jcdd13040149

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Estimated Pulse Wave Velocity as a Marker of Blood-Pressure-Dependent Arterial Load and Ventricular–Vascular Interaction in Severe Aortic Stenosis Before and After Transcatheter Aortic Valve Replacement

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Estimated Pulse Wave Velocity as a Marker of Blood-Pressure-Dependent Arterial Load and Ventricular–Vascular Interaction in Severe Aortic Stenosis Before and After Transcatheter Aortic Valve Replacement

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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