Cardiac remodelling following thoracic endovascular aortic repair for descending aortic aneurysms.
Aged
Aorta, Thoracic
/ diagnostic imaging
Aortic Aneurysm, Thoracic
/ diagnosis
Aortography
Blood Vessel Prosthesis Implantation
/ methods
Computed Tomography Angiography
Echocardiography
Endovascular Procedures
/ methods
Female
Follow-Up Studies
Heart Ventricles
/ diagnostic imaging
Humans
Male
Postoperative Period
Prognosis
Prosthesis Design
Retrospective Studies
Stroke Volume
/ physiology
Ventricular Function, Left
/ physiology
Ventricular Remodeling
Cardiac remodelling
Computational modelling
Stroke work
Thoracic endovascular aortic repair
Journal
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
ISSN: 1873-734X
Titre abrégé: Eur J Cardiothorac Surg
Pays: Germany
ID NLM: 8804069
Informations de publication
Date de publication:
01 Jun 2019
01 Jun 2019
Historique:
received:
24
08
2018
revised:
27
10
2018
accepted:
29
10
2018
pubmed:
12
12
2018
medline:
2
10
2020
entrez:
12
12
2018
Statut:
ppublish
Résumé
Current endografts for thoracic endovascular aortic repair (TEVAR) are much stiffer than the aorta and have been shown to induce acute stiffening. In this study, we aimed to estimate the impact of TEVAR on left ventricular (LV) stroke work (SW) and mass using a non-invasive image-based workflow. The University of Michigan database was searched for patients treated with TEVAR for descending aortic pathologies (2013-2016). Patients with available pre-TEVAR and post-TEVAR computed tomography angiography and echocardiography data were selected. LV SW was estimated via patient-specific fluid-structure interaction analyses. LV remodelling was quantified through morphological measurements using echocardiography and electrocardiographic-gated computed tomography angiography data. Eight subjects were included in this study, the mean age of the patients was 68 (73, 25) years, and 6 patients were women. All patients were prescribed antihypertensive drugs following TEVAR. The fluid-structure interaction simulations computed a 26% increase in LV SW post-TEVAR [0.94 (0.89, 0.34) J to 1.18 (1.11, 0.65) J, P = 0.012]. Morphological measurements revealed an increase in the LV mass index post-TEVAR of +26% in echocardiography [72 (73, 17) g/m2 to 91 (87, 26) g/m2, P = 0.017] and +15% in computed tomography angiography [52 (46, 29) g/m2 to 60 (57, 22) g/m2, P = 0.043]. The post- to pre-TEVAR LV mass index ratio was positively correlated with the post- to pre-TEVAR ratios of SW and the mean blood pressure (ρ = 0.690, P = 0.058 and ρ = 0.786, P = 0.021, respectively). TEVAR was associated with increased LV SW and mass during follow-up. Medical device manufacturers should develop more compliant devices to reduce the stiffness mismatch with the aorta. Additionally, intensive antihypertensive management is needed to control blood pressure post-TEVAR.
Identifiants
pubmed: 30535179
pii: 5232605
doi: 10.1093/ejcts/ezy399
pmc: PMC6537936
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1061-1070Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL105297
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL135842
Pays : United States
Informations de copyright
© The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Références
J Am Coll Cardiol. 2002 Aug 21;40(4):773-9
pubmed: 12204510
J Thorac Cardiovasc Surg. 2002 Oct;124(4):768-74
pubmed: 12324735
Circ Res. 1992 Sep;71(3):490-502
pubmed: 1386792
J Am Soc Echocardiogr. 2005 Dec;18(12):1440-63
pubmed: 16376782
Eur J Vasc Endovasc Surg. 2006 Aug;32(2):129-35
pubmed: 16564712
J Cardiovasc Magn Reson. 2006;8(3):417-26
pubmed: 16755827
J Endovasc Ther. 2007 Aug;14(4):544-50
pubmed: 17696631
J Biomech. 2008 Aug 7;41(11):2370-8
pubmed: 18644312
Comput Methods Biomech Biomed Engin. 2010 Oct;13(5):625-40
pubmed: 20140798
Circulation. 2010 Apr 6;121(13):e266-369
pubmed: 20233780
Eur J Vasc Endovasc Surg. 2010 Jun;39(6):693-9
pubmed: 20452789
Eur J Vasc Endovasc Surg. 2011 Nov;42(5):704-10
pubmed: 21889370
Ann Vasc Surg. 2012 May;26(4):462-7
pubmed: 22284778
Eur J Vasc Endovasc Surg. 2013 Feb;45(2):154-9
pubmed: 23280314
J Mech Behav Biomed Mater. 2014 Jan;29:618-34
pubmed: 23499251
Circ J. 2014;78(2):322-8
pubmed: 24292128
J Am Coll Cardiol. 2014 Dec 23;64(24):2619-2629
pubmed: 25524341
Circ Res. 2016 Feb 5;118(3):379-81
pubmed: 26846637
Am J Physiol Heart Circ Physiol. 2016 May 1;310(9):H1242-58
pubmed: 26945076
J Vis Exp. 2016 Feb 16;(108):53603
pubmed: 26967592
BMJ Open. 2016 Nov 17;6(11):e012270
pubmed: 27856475
PLoS One. 2017 Oct 5;12(10):e0186080
pubmed: 28982135
Eur J Cardiothorac Surg. 2018 Aug 1;54(2):389-396
pubmed: 29554234
Ann Cardiothorac Surg. 2018 May;7(3):406-413
pubmed: 30155420
AJR Am J Roentgenol. 1981 Nov;137(5):903-7
pubmed: 7027775
J Am Coll Cardiol. 1993 May;21(6):1497-506
pubmed: 8473662
Circulation. 1996 Nov 15;94(10):2497-506
pubmed: 8921794
Circulation. 1997 Jan 7;95(1):151-5
pubmed: 8994430