Key result
Transcatheter aortic valve replacement induced an increase in blood pressure requiring additional antihypertensives, with a positive correlation between changes in pulse pressure and stroke volume index.
Why the study?
The short-term effects of TAVR on blood pressure and cardiac function in elderly and high-risk patients with severe aortic stenosis were not clear.
Does transcatheter aortic valve replacement affect short-term blood pressure and cardiac function in elderly patients with severe aortic stenosis?
Observational (n=28)
Does transcatheter aortic valve replacement affect short-term blood pressure and cardiac function in elderly patients with severe aortic stenosis?
TAVR in elderly patients with severe aortic stenosis can lead to short-term post-procedural hypertension driven by increases in stroke volume index and pulse pressure, particularly in those with less advanced arteriosclerosis.
Answers are grounded in this paper and cite their sources.
Post-TAVR BP rise may warrant closer short-term monitoring; leaves open causality and outcome impact in observational data.
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a standard treatment for elderly and high-risk patients with aortic valve stenosis (AS); however, its short-term effects on blood pressure (BP) and cardiac function are not clear. Therefore, we aimed to determine the short-term effects of TAVR in elderly patients (>75 years), who reflect the clinical situation in Japan. METHOD AND RESULTS: Twenty-eight consecutive elderly patients with severe AS and hypertension who underwent TAVR under general anesthesia were retrospectively investigated. All patients had hypertension that was well controlled with antihypertensive drugs. Serum brain natriuretic peptide level and peak velocity in the aortic valve were significantly reduced. TAVR induces an increase in BP that requires additional antihypertensive agents. There was no correlation between the change rate of SBP and stroke volume index (SVI), but there was a positive correlation between the rate of change in pulse pressure (PP) and SVI. This tendency was particularly observed in patients with low brachial-ankle pulse wave velocity (baPWV). CONCLUSION: We observed post-TAVR hypertension and required additional antihypertensive drugs. The increases in SVI and PP after TAVR resulted in post-TAVR hypertension. Moreover, post-TAVR hypertension is less likely to occur in elderly patients with a high baPWV, which indicates advanced arteriosclerosis.
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Aoyama et al. (2022) conducted an observational in Severe aortic stenosis and hypertension (n=28). Transcatheter aortic valve replacement (TAVR) was evaluated on Blood pressure and cardiac function. Transcatheter aortic valve replacement induced an increase in blood pressure requiring additional antihypertensives, with a positive correlation between changes in pulse pressure and stroke volume index.
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