Sahrai Saeed1, Nasir Saeed2, Karine Grigoryan3, Phil Chowienczyk4, John B Chambers3, Ronak Rajani3. 1. Department of Heart Disease, Haukeland University Hospital, Bergen, Norway. Electronic address: sahrai.saeed@helse-bergen.no. 2. Faculty of Medicine, University of Bergen, Bergen, Norway. 3. Cardiothoracic Centre, Guy's & St Thomas' Hospital, London, United Kingdom. 4. King's College London, London, United Kingdom.
Abstract
BACKGROUND: Patients with degenerative aortic stenosis (AS) are often older and have systemic hypertension and atherosclerosis, which all lead to increased aortic stiffness. We aimed to assess the determinants of carotid-femoral pulse wave velocity (cf-PWV), a direct measure of aortic stiffness, and its association with revealed symptoms and clinical outcome in patients with AS. METHODS: We included 103 asymptomatic patients aged 66.6 ± 13.2 years (range 27-85 years, 69% males) with moderate (n = 50) and severe (n = 53) AS. All underwent a comprehensive echocardiography, exercise treadmill test (ETT) and assessment of aortic stiffness derived from cf-PWV by applanation tonometry. RESULTS: The mean cf-PWV was 10.6 ± 3.1 m/s and resting brachial blood pressure (BP) 139 ± 20/79 ± 11 mmHg. Increased cf-PWV (≥10 m/s) was found in 44% (n = 45) patients. Patients with moderate and severe AS had a similar degree of aortic stiffness (cf-PWV 10.7 ± 3.3 vs. 10.5 ± 3.0 m/s, p = 0.698). In a univariate logistic regression analysis, higher cf-PWV was not associated with revealed symptoms (odds ratio [OR] for 1SD higher cf-PWV 1.12; 95% CI 0.62-2.04, p = 0.706). In a multivariable linear regression analysis, age, resting brachial systolic BP and diabetes were associated with higher cf-PWV independent of antihypertensive treatment and left ventricular ejection fraction. The event-free survival was significantly lower in patients with cf-PWV ≥10 m/s compared to those with cf-PWV <10 m/s (p = 0.015). CONCLUSION: Increased cf-PWV was common in patients with moderate or severe AS, and was associated with higher cardiovascular disease burden and impaired prognosis. cf-PWV did not correlate with the severity of AS or the frequencies of revealed symptoms by ETT.
BACKGROUND: Patients with degenerative aortic stenosis (AS) are often older and have systemic hypertension and atherosclerosis, which all lead to increased aortic stiffness. We aimed to assess the determinants of carotid-femoral pulse wave velocity (cf-PWV), a direct measure of aortic stiffness, and its association with revealed symptoms and clinical outcome in patients with AS. METHODS: We included 103 asymptomatic patients aged 66.6 ± 13.2 years (range 27-85 years, 69% males) with moderate (n = 50) and severe (n = 53) AS. All underwent a comprehensive echocardiography, exercise treadmill test (ETT) and assessment of aortic stiffness derived from cf-PWV by applanation tonometry. RESULTS: The mean cf-PWV was 10.6 ± 3.1 m/s and resting brachial blood pressure (BP) 139 ± 20/79 ± 11 mmHg. Increased cf-PWV (≥10 m/s) was found in 44% (n = 45) patients. Patients with moderate and severe AS had a similar degree of aortic stiffness (cf-PWV 10.7 ± 3.3 vs. 10.5 ± 3.0 m/s, p = 0.698). In a univariate logistic regression analysis, higher cf-PWV was not associated with revealed symptoms (odds ratio [OR] for 1SD higher cf-PWV 1.12; 95% CI 0.62-2.04, p = 0.706). In a multivariable linear regression analysis, age, resting brachial systolic BP and diabetes were associated with higher cf-PWV independent of antihypertensive treatment and left ventricular ejection fraction. The event-free survival was significantly lower in patients with cf-PWV ≥10 m/s compared to those with cf-PWV <10 m/s (p = 0.015). CONCLUSION: Increased cf-PWV was common in patients with moderate or severe AS, and was associated with higher cardiovascular disease burden and impaired prognosis. cf-PWV did not correlate with the severity of AS or the frequencies of revealed symptoms by ETT.
Authors: Jakub Baran; Anna Kablak-Ziembicka; Pawel Kleczynski; Ottavio Alfieri; Łukasz Niewiara; Rafał Badacz; Piotr Pieniazek; Jacek Legutko; Krzysztof Zmudka; Tadeusz Przewlocki; Jakub Podolec Journal: J Clin Med Date: 2022-04-07 Impact factor: 4.964
Authors: Jakub Baran; Paweł Kleczyński; Łukasz Niewiara; Jakub Podolec; Rafał Badacz; Andrzej Gackowski; Piotr Pieniążek; Jacek Legutko; Krzysztof Żmudka; Tadeusz Przewłocki; Anna Kabłak-Ziembicka Journal: J Clin Med Date: 2021-05-13 Impact factor: 4.241