Transcatheter aortic valve replacement (TAVR) leads to an increase in the subendocardial viability ratio assessed by pulse wave analysis

Pulse wave analysis (PWA) is a useful tool for non-invasive assessment of central cardiac measures as subendocardial perfusion (Subendocardial Viability Ratio, SEVR) or contractility (dP/dtmax). The immediate influence of transcatheter aortic valve replacement (TAVR) on these indices has not been in...

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Published in:PloS one 2018-11, Vol.13 (11), p.e0207537-e0207537
Main Authors: Müller, Claudia, Goliasch, Georg, Schachinger, Stefan, Kastl, Stefan, Neunteufl, Thomas, Delle-Karth, Georg, Kastner, Johannes, Gyöngyösi, Mariann, Lang, Irene, Gottsauner-Wolf, Michael, Pavo, Noemi
Format: Article
Language:English
Subjects:
Aorta
Aortic stenosis
Aortic valve
Augmentation
Biology and Life Sciences
Blood pressure
Cardiology
Cardiovascular disease
Coronary vessels
Electrocardiography
Heart rate
Hemodynamics
Hypertension
Internal medicine
Ischemia
Medicine
Medicine and Health Sciences
Mortality
Muscle contraction
Parameters
Perfusion
Physical Sciences
Pressure
Stenosis
Stiffness
Systematic review
Viability
Wave analysis
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Summary:Pulse wave analysis (PWA) is a useful tool for non-invasive assessment of central cardiac measures as subendocardial perfusion (Subendocardial Viability Ratio, SEVR) or contractility (dP/dtmax). The immediate influence of transcatheter aortic valve replacement (TAVR) on these indices has not been investigated yet. We prospectively enrolled 40 patients presenting with severe aortic stenosis receiving TAVR. Central pressure curves were derived from radial and carotid sites using PWA up to 2 days before and 7 days after TAVR. Parameters were compared between peripheral measurement sites. Changes in SEVR, dP/dtmax and in indices of vascular stiffness were assessed. Additionally, association of these variables with clinical outcome was evaluated during a 12-month follow-up. Central waveform parameters were comparable between measurement sites. SEVR, but not dP/dtmax, augmentation Index (AIx) or augmentation pressure height (AGPH) correlated significantly with disease severity reflected by peak transvalvular velocity and mean transvalvular pressure gradient over the aortic valve (Vmax, ΔPm) [r = -0.372,p = 0.029 for Vmax and r = -0.371,p = 0.021 for ΔPm]. Vmax decreased from 4.5m/s (IQR:4.1-5.0) to 2.2m/s (IQR:1.9-2.7), (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0207537