Impact of TAVI on Valvulo-Arterial Impedance and Systemic Arterial Distensibility in Patients with Severe Aortic Stenosis | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 50, Volume 97, Issue 1, October 2024, Pages 3754-3759 PDF (317.51 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2024.388699 | ||
| Abstract | ||
| Background: Calcific aortic stenosis (AS) involves progressive valve narrowing and increased left ventricle (LV) afterload. Transcatheter aortic valve implantation (TAVI) offers an alternative to surgery for high-risk patients. Its effect on systemic arterial properties, including valvulo-arterial impedance (ZVa) and systemic arterial distensibility (SAD), is vital for improving outcomes. Objective: To investigate the effects of TAVI on LV afterload, focusing on ZVa and SAD in patients with severe AS. Patients and Methods: This analytic cross-sectional study included 50 patients with severe symptomatic aortic stenosis, who underwent TAVI. Comprehensive echocardiographic and hemodynamic assessments were performed before and six months post-TAVI at the Cardiology Department of Nasr City Hospital and Mansoura University Hospital. Results: TAVI resulted in a significant reduction in both systolic blood pressure (SBP) (p < 0.0001) and diastolic blood pressure (DBP) (p = 0.038). Mean aortic gradient decreased markedly from 54.69 ± 15.64 to 8.45 ± 5.21 mmHg (p < 0.0001), while SV and stroke volume index (SVI) increased significantly (SV: 71.93 ± 10.31 to 97.19 ± 17.20 mL; SVI: 38.88 ± 5.60 to 51.66 ± 9.68 mL/m², p < 0.0001). Although ZVa showed a slight increase from 5.20 ± 1.04 to 5.56 ± 0.49 mmHg/mL/m² (p < 0.0001), SVR decreased significantly from 2.15 ± 3.32 to 1.14 ± 0.23 dyn/sec/cm (p = 0.034). SAD demonstrated substantial improvement, increasing from 0.66 ± 0.20 to 1.25 ± 0.31 mL/mmHg (p < 0.0001). Conclusion: TAVI significantly improves systemic arterial distensibility, contributing to a more favourable hemodynamic profile in patients with severe AS. | ||
| Keywords | ||
| Aortic stenosis; TAVI; Valvulo-arterial impedance; Systemic arterial distensibility; Hemodynamics | ||
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