Endovascular aortic repair impact on myocardial contractility: A prospective study.
abdominal aortic aneurysm
arterial stiffness
contractile function
endovascular aortic repair
left ventricular afterload
single photon emission computed tomography
Journal
European journal of clinical investigation
ISSN: 1365-2362
Titre abrégé: Eur J Clin Invest
Pays: England
ID NLM: 0245331
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
revised:
07
04
2023
received:
11
02
2023
accepted:
24
04
2023
medline:
21
8
2023
pubmed:
26
4
2023
entrez:
26
4
2023
Statut:
ppublish
Résumé
This study aimed to estimate if the altered sphygmic wave transmission may affect the left ventricular (LV) contractile function in patients undergoing endovascular aortic repair (EVAR). A prospective single-centre study was carried out on consecutive patients undergoing EVAR for abdominal aortic aneurysm. A preoperative and 6-month single photon emission computed tomography (SPECT) with arterial stiffness measurement were performed to evaluate variations in pressure wave curve and myocardial perfusion parameters. From 2018 to 2020 a total of 16 patients were included in the study. Among the parameters evaluated, we found a measurable reduction of the reflected wave transit time from pre- to postoperative period, for both stress (115.13 ± 7.2 ms-111.1 ± 7.0 ms, p = .08) and rest SPECT acquisitions (115.3 ± 6.2 ms-112.2 ± 5.6 ms, p = .1). Unidirectional increase of both LV end-systolic volume (34 ± 9 mL-39 ± 8 mL, p = .02) and end-diastolic volume (85 ± 34 mL-89 ± 29 mL, p = .6) was also observed. Lastly, the ratio between the end-systolic pressure and the end-systolic volume (maximal systolic myocardial stiffness) decreased from 3.6 ± 1.5 mmHg/mL to 2.66 ± .74 mmHg/mL (p = .03). Our data showed that EVAR induced an altered transmission of the sphygmic wave associated with an early LV contractile impairment.
Sections du résumé
BACKGROUND
BACKGROUND
This study aimed to estimate if the altered sphygmic wave transmission may affect the left ventricular (LV) contractile function in patients undergoing endovascular aortic repair (EVAR).
METHODS
METHODS
A prospective single-centre study was carried out on consecutive patients undergoing EVAR for abdominal aortic aneurysm. A preoperative and 6-month single photon emission computed tomography (SPECT) with arterial stiffness measurement were performed to evaluate variations in pressure wave curve and myocardial perfusion parameters.
RESULTS
RESULTS
From 2018 to 2020 a total of 16 patients were included in the study. Among the parameters evaluated, we found a measurable reduction of the reflected wave transit time from pre- to postoperative period, for both stress (115.13 ± 7.2 ms-111.1 ± 7.0 ms, p = .08) and rest SPECT acquisitions (115.3 ± 6.2 ms-112.2 ± 5.6 ms, p = .1). Unidirectional increase of both LV end-systolic volume (34 ± 9 mL-39 ± 8 mL, p = .02) and end-diastolic volume (85 ± 34 mL-89 ± 29 mL, p = .6) was also observed. Lastly, the ratio between the end-systolic pressure and the end-systolic volume (maximal systolic myocardial stiffness) decreased from 3.6 ± 1.5 mmHg/mL to 2.66 ± .74 mmHg/mL (p = .03).
CONCLUSIONS
CONCLUSIONS
Our data showed that EVAR induced an altered transmission of the sphygmic wave associated with an early LV contractile impairment.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14011Informations de copyright
© 2023 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.
Références
Suckow BD, Goodney PP, Columbo JA, et al. National trends in open surgical, endovascular, and branched-fenestrated endovascular aortic aneurysm repair in Medicare patients. J Vasc Surg. 2018;67(6):1690-1697.e1.
Chaikof EL, Dalman RL, Eskandari MK, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg. 2018;67(1):2-77.e2. doi:10.1016/j.jvs.2017.10.044
Wanhainen A, Verzini F, Van Herzeele I, et al. Editor's choice - European Society for Vascular Surgery (ESVS) 2019 clinical practice guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms. Eur J Vasc Endovasc Surg. 2019;57(1):8-93.
Li B, Khan S, Salata K, et al. A systematic review and meta-analysis of the long-term outcomes of endovascular versus open repair of abdominal aortic aneurysm. J Vasc Surg. 2019;70(3):954-969.e30.
Antoniou GA, Antoniou SA, Torella F. Editor's choice - endovascular vs. open repair for abdominal aortic aneurysm: systematic review and meta-analysis of updated Peri-operative and long term data of randomised controlled trials. Eur J Vasc Endovasc Surg. 2020;59(3):385-397.
Takeda Y, Sakata Y, Ohtani T, et al. Endovascular aortic repair increases vascular stiffness and alters cardiac structure and function. Circ J. 2014;78(2):322-328.
Spinella G, Pane B, Bonfiglio A, et al. In vitro evaluation of upstream and downstream influences on blood pressure of the hybrid treatment of thoracoabdominal aortic aneurysms. Ann Vasc Surg. 2016;36:283-288.
Spinella G, Finotello A, Conti M, et al. Assessment of geometrical remodelling of the aortic arch after hybrid treatment. Eur J Cardiothorac Surg. 2019;55(6):1045-1053.
van Bakel T, Arthurs CJ, Nauta F, et al. Cardiac remodelling following thoracic endovascular aortic repair for descending aortic aneurysms. Eur J Cardiothorac Surg. 2019;55(6):1061-1070.
Sultan S, Acharya Y, Hazima M, Salahat H, Parodi JC, Hynes N. Combined thoracic endovascular aortic repair and endovascular aneurysm repair and the long-term consequences of altered cardiovascular haemodynamics on morbidity and mortality: case series and literature review. Eur Heart J Case Rep. 2021;5(10):ytab339.
Georgakarakos E. Estimating the influence of aortic-stent grafts after endovascular aneurysm repair: are we missing something? Med Hypotheses. 2016;97:26-30.
Roos CJ, Djaberi R, Schuijf JD, et al. Relationship between vascular stiffness and stress myocardial perfusion imaging in asymptomatic patients with diabetes. Eur J Nucl Med Mol Imaging. 2011;38(11):2050-2057.
Yannoutsos A, Ahouah M, Dreyfuss Tubiana C, Topouchian J, Safar ME, Blacher J. Aortic stiffness improves the prediction of both diagnosis and severity of coronary artery disease. Hypertens Res. 2018;41(2):118-125.
Marketou M, Papadopoulos G, Kontopodis N, et al. Early left ventricular global longitudinal strain deterioration after aortic aneurysm repair: impact of aortic stiffness. J Endovasc Ther. 2021;28(2):352-359.
Mirsky I, Tajimi T, Peterson KL. The development of the entire end-systolic pressure-volume and ejection fraction-afterload relations: a new concept of systolic myocardial stiffness. Circulation. 1987;76(2):343-356.
Milan A, Zocaro G, Leone D, et al. Current assessment of pulse wave velocity: comprehensive review of validation studies. J Hypertens. 2019;37(8):1547-1557.
Nakae I, Matsuo S, Tsutamoto T, Matsumoto T, Mitsunami K, Horie M. Assessment of cardiac function in patients with heart disease by quantitative gated myocardial perfusion SPECT. Ann Nucl Med. 2007;21(6):315-323.
Klaeboe LG, Edvardsen T. Echocardiographic assessment of left ventricular systolic function. J Echocardiogr. 2019;17(1):10-16.
Simera I, Moher D, Hoey J, Schulz KF, Altman DG. A catalogue of reporting guidelines for health research. Eur J Clin Invest. 2010;40(1):35-53.
Eagle KA, Berger PB, Calkins H, et al. ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery-executive summary. A report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee to update the 1996 guidelines on perioperative cardiovascular evaluation for noncardiac surgery). Anesth Analg. 2002;94(5):1052-1064.
Butlin M, Qasem A. Large artery stiffness assessment using SphygmoCor technology. Pulse. 2017;4(4):180-192.
Nishibe T, Kano M, Maekawa K, et al. Association of preoperative pulse wave velocity to aneurysm sac shrinkage after endovascular aneurysm repair. Int Angiol. 2021;40(5):409-415.
Dobson G, Flewitt J, Tyberg JV, Moore R, Karamanoglu M. Endografting of the descending thoracic aorta increases ascending aortic input impedance and attenuates pressure transmission in dogs. Eur J Vasc Endovasc Surg. 2006;32(2):129-135.
Baan J, Jong TT, Kerkhof PL, et al. Continuous stroke volume and cardiac output from intra-ventricular dimensions obtained with impedance catheter. Cardiovasc Res. 1981;15(6):328-334.
Yalçin F, Yalçin H, Küçükler N, Abraham TP. Quantitative left ventricular contractility analysis under stress: a new practical approach in follow-up of hypertensive patients. J Hum Hypertens. 2011;25(10):578-584.
Braunwald E. Biomarkers in heart failure. N Engl J Med. 2008;358(20):2148-2159.
Bissacco D, Conti M, Domanin M, et al. Modifications in aortic stiffness after endovascular or open aortic repair: a systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 2022;63(4):567-577.