P61 Arterial Stiffness is Associated with Aortic Valve Calcifications

Abstract

Purpose/Background/Objective

Arterial stiffness and aortic hemodynamics are independent predictors of adverse cardiovascular events. Indications for Transcatheter Aortic Valve Implantation (TAVI) are increasing in number and Aortic Valve Calcifications (AVC) are an important prognostic factor of TAVI. We sought to investigate the associations between AVC and aortic vascular function/hemodynamics.

Methods

Fifty-two high-risk patients (mean age 80.4 ± 8.5 years, 27 male) with severe symptomatic aortic stenosis undergoing TAVI were included. Arterial stiffness was estimated through carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle pulse wave velocity (baPWV). Aortic hemodynamics were also measured. Measurements were conducted prior to the implantation and at discharge. In all patients, a native and contrast-enhanced multislice cardiac computed tomography were performed pre-interventionally. AVC were then graded semi-quantitatively.

Results

Group 1 (subjects with none/mild AVC, n = 29) did not significantly differ on age, gender and body-mass index compared to group 2 (subjects with moderate/severe AVC, n = 23). From the traditional cardiovascular risk factors, only hypertension (p = 0.008), coronary artery disease (p = 0.016), atrial fibrillation (p = 0.075) and insulin-dependent diabetes mellitus (p = 0.068) were more statistically or showed a significant trend to be more prevalent in group 2. Group 2 had significantly higher both cfPWV and baPWV (8.3 ± 1.7 vs 7.2 ±1.2 m/s and 1750 ± 484 cm/s vs. 2101 ± 590 cm/s with p = 0.008 and p = 0.022 respectively) compared to Group 1. (Figure) There was no difference in wave reflections indices between the two groups.

Conclusions

Our study shows that in patients with aortic stenosis there is a correlation between an increase in aortic stiffness and damage of aortic valvular leaflets as well as calcifications.