- ARTERY 18 Poster Session
- Poster Session I - Interventions
- Open access
- Published:
P66 Reduction in Augmentation Pressure is Associated with Improvement of Early Ventricular Ejection after Aortic Valve Replacement
Artery Research volume 24, page 97 (2018)
Abstract
Background
Previously regarded as a measure of pressure wave reflection, central augmentation pressure (AP) may be influenced by the pattern of early ventricular ejection. We examined the relationship of AP to first-phase ejection fraction (EF1), a measure of ventricular ejection up to the time of the first systolic peak in central pressure in patients with aortic stenosis (AS) before and after aortic valve replacement (AVR).
Methods
Carotid pressure, obtained by tonometry calibrated from peripheral mean and diastolic blood pressure, was used to calculate augmentation pressure (difference between the second and first systolic peaks of the aortic waveform). LV volume was obtained by echocardiography. EF1 was defined as the fraction of LV volume ejected from the start of systole to the time of the first systolic peak (T1) on the carotid pressure waveform. Aortic arch to abdominal aorta pulse wave velocity (aPWV) was measured by pulsed wave Doppler.
Results
10 patients with severe AS (aged 75.8 ± 7.8 years) and preserved EF (62.2 ± 7.1%) were studied before and 48–72 hours after AVR. There was a significant reduction in mean arterial pressure (MAP) (pre:96.9 ± 12.3 mmHg vs post:83.4 ± 11.2 mmHg, p = 0.012) and AP (pre:20.8 ± 11.4 mmHg vs post:11.0 ± 5.8 mmHg, p = 0.017). EF1 improved significantly (pre:18.7 ± 6.8% vs post:28.9 ± 12.4%, p = 0.043), whilst EF did not change. aPWV didn’t change significantly after AVR. The change in EF1 was negatively associated with change in AP (β = −0.841, p = 0.002) (Figure 1). This relationship persisted after adjustment of age, gender, BMI, baseline MAP and aortic valve area (β = −1.095, p = 0.033).
Conclusion
In patients with AS and preserved EF, an improvement of early ejection is associated with reduction in augmentation pressure after AVR.
![](http://media.springernature.com/lw685/springer-static/image/art%3A10.1016%2Fj.artres.2018.10.119/MediaObjects/44200_2018_2401113_Fig1.jpg)
Central aortic pressure waveforms in one subject pre (blue line) and post (red line) AVR. Augmentation pressure reduced from 16mmHg to 4mmHg, whilst EF1 increased from 17.7% to 37.7% after AVR
Author information
Authors and Affiliations
Rights and permissions
This is an open access article distributed under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).
About this article
Cite this article
Gu, H., Rajani, R. & Chowienczyk, P. P66 Reduction in Augmentation Pressure is Associated with Improvement of Early Ventricular Ejection after Aortic Valve Replacement. Artery Res 24, 97 (2018). https://doi.org/10.1016/j.artres.2018.10.119
Published:
Issue Date:
DOI: https://doi.org/10.1016/j.artres.2018.10.119