Key result
TAVI is linked to improved carotid arterial stiffness, increasing peak circumferential strain by ~0.6 percentage points.
Why the study?
Studies assessing the impact of aortic valve replacement on arterial stiffness have yielded equivocal results.
Does TAVI improve arterial stiffness of the common carotid artery measured by 2D speckle tracking in patients with severe aortic stenosis?
Observational (n=47)
No
Does TAVI improve arterial stiffness of the common carotid artery measured by 2D speckle tracking in patients with severe aortic stenosis?
Absolute Event Rate: 5.12% vs 4.5%
p-value: p=0.012
TAVI leads to significant short-term improvements in peripheral arterial stiffness in the common carotid artery, measurable by non-invasive 2D speckle tracking.
May improve carotid stiffness after TAVI; hypothesis-generating and should not yet change practice pending RCTs.
Arterial stiffness has received increasing interest as a cardiovascular marker in patients with aortic valve stenosis (AS). So far, studies on the impact of aortic valve replacement (AVR) on arterial stiffness have been equivocal. Two-dimensional speckle tracking (2DST) is a novel, non-invasive method to measure the motion of the vessel wall. In this prospective observational study, we aimed to assess the change in arterial stiffness of the common carotid artery (CCA) measured by 2DST in patients undergoing transcatheter aortic valve implantation (TAVI). A total of 47 patients were included in the study (age 80.04 ± 6.065 years). Peak circumferential strain (CS) was significantly improved after TAVI (4.50 ± 2.292 vs. 5.12 ± 2.958, p = 0.012), as was the peak strain rate (CSR) (0.85 ± 0.567 vs. 1.35 ± 0.710, p = 0.002). Body mass index (BMI), mean arterial pressure (MAP) and hemodynamic parameters were associated with this change. 2DST results did not correlate with aortic pulse wave velocity (aPWV) or augmentation index normalized to heart rate (AIx@75), suggesting a distinct difference between arterial stiffness of the CCA and other stiffness parameters. 2DST seems to be a promising new tool to assess arterial stiffness in TAVI patients.
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Arnold et al. (2023) conducted an observational in Severe aortic valve stenosis (n=47). Transcatheter aortic valve implantation (TAVI) vs. Pre-TAVI baseline was evaluated on Peak circumferential strain (CS) measured by 2D speckle tracking (p=0.012). TAVI significantly improved arterial stiffness of the common carotid artery, measured as an increase in peak circumferential strain from 4.50% to 5.12%.
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