Abstract 18050: The Endovascular Stent Graft Raises Vascular Stiffness and Changes Cardiac Structure within a Very Short Term.
Background: The endovascular stent graft is used in the growing number of patients with thoracic or abdominal aortic aneurysm (TAA, AAA) because it is less invasive. However, the effects of this procedure on vascular and cardiac function remain to be clarified.
Methods: Echocardiographic study and the evaluation of the brachial-ankle pulse wave velocity (baPWV) were conducted before (pre-op) and after the endovascular stent grafting (post-op) in 45 consecutive patients with AAA or TAA. Patients were excluded if they had LV ejection fraction (EF)<40%, moderate-to-severe valvular diseases, aortic dissection and renal failure.
Result: The mean age of the study subjects was 72±7 years old. Post-op data were collected around a week after the operation. Systolic blood pressure was significantly decreased and baPWV and heart rate were significantly elevated after the grafting. There was no difference in LV end-diastolic volume, EF, indices of transmitral flow velocity curves, a ratio of transmitral E velocity to early diastolic mitral annular velocity (E/E′), and inferior vena cava dimension between pre-op and post-op status. However, LV mass and left atrial volume significantly increased at post-op status. The changes in LV mass were positively correlated with those in baPWV (p<0.05, R=0.34).
Conclusion: The endovascular stent graft raised vascular stiffness and induced LV hypertrophy within the very short term after the operation without elevation of blood pressure. The associated left atrial enlargement suggests the development of LV diastolic dysfunction, although the changes in the indices of the transmitral flow velocity curves or E/E′ were lacking. The long-term observational study is required to assess the effects of the stent grafting on vascular and cardiac function.
- © 2010 by American Heart Association, Inc.