Abstract 17662: Measures of Carotid-Femoral Pulse Wave Velocity and Carotid Augmentation Index Are not Reliable in Patients with Abdominal Aortic Aneurysm
Both wave reflections and arterial stiffness are standard measurements of vascular aging, which correlates with cardiovascular morbidities and mortalities in various populations. Abdominal aortic aneurysm (AAA) is a life-threatening disease involving a segmentally dilated aorta, and the endovascular repair is one of the effective treatments. The alternations of arterial properties, in terms of wave reflections and arterial stiffness, before and after endovascular surgery have not yet been fully understood. We therefore investigated the wave reflections and arterial stiffness in patients with AAA, comparing to a control population.A total of 51 patients (75.2±11.6 years) underwent endovascular stent grafting for AAA and 51 age, sex, and systolic blood pressure (SBP)-matched subjects were enrolled. Measures of the pulsatile hemodynamics including carotid and brachial systolic and diastolic blood pressure (cSBP, cDBP and bSBP, bDBP), carotid augmentation index (cAI), carotid augmented pressure (cAP), carotid-femoral pulse wave velocity (cf-PWV), and carotid-brachial PWV (cb-PWV), as well as the forward pressure wave amplitude (Pf) and reflected pressure wave amplitude (Pb) from a decomposed carotid pressure wave were obtained before and 4 weeks after endovascular surgery.The patients with AAA had significant lower cf-PWV (1192.52±284.41 vs. 1360.44±347.75, p=0.009), higher cAI (30.8±12.2 vs. 23.1±23.3, p=0.040), and similar ba-PWV, cb-PWV, cAP, and Pb comparing to the control group. After the endovascular stent graft for AAA, the patients would have significantly lower brachial and carotid SBP, higher cf-PWV (before vs. after: 1192.52±284.41 vs. 1444.05±377.25, p<0.001), higher ba-PWV (before vs. after: 1421.72± 290.90 vs. 1514.94± 400.59, p=0.030), lower cb-PWV (before vs. after: 1134.70± 452.69 vs. 1075.67± 409.47, p=0.008), and lower cAI (30.8±12.2 vs. 24.4±14.5, p=0.011). After endovascular stent implantation, only cf-PWV and ba-PWV increased while Pb and cAP did not significantly change after adjusting bSBP.cf-PWV may underestimate arterial stiffness and cAI may overestimate wave reflection in patients with AAA before treatment. Pb and ba-PWV may be more reasonable surrogate measures for vascular aging in AAA patients.
- © 2012 by American Heart Association, Inc.