Aortic valve sclerosis is a sign of increased arterial stiffness in clinically asymptomatic subjects

Korkmaz, Levent; Ağaç, Mustafa Tarık; Bektaş, H.; Varol, Mustafa Oğuz; Erkan, Hakan; Acar, Zeydin; Kurt, Devrim; Çelık, Şükrü

doi:10.5603/cj.2013.0078

Cited by 9 publications

(11 citation statements)

References 26 publications

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“…The results of the present study implicate that by normalizing the ET through AVR, the arterial stiffness can appropriately be captured resulting in an increased CAVI. The increased CAVI observed in AVSc patients without significantly affected hemodynamics support this hypothesis ( 5 ).…”

Section: Discussionmentioning

confidence: 83%

“…The pathophysiological processes in AVS share many features with atherosclerosis which is associated with arterial stiffness ( 1 ). A connection between arterial stiffness and AVS is supported by the association of aortic valve calcification and arterial stiffness ( 2 ), measured as either increased carotid femoral pulse wave velocity (cfPWV) in patients with aortic stenosis ( 3 ) or a higher cardio ankle vascular index (CAVI) ( 4 ) in patients with AVSc compared with controls ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

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Cardiovascular Risk Factors and Hemodynamic Measures as Determinants of Increased Arterial Stiffness Following Surgical Aortic Valve Replacement

Plunde

Franco‐Cereceda

Bäck

2021

Front. Cardiovasc. Med.

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Valvular and arterial function are tightly intertwined, both in terms of structural changes and hemodynamics. While proximal valvulo-vascular coupling contributes to the cardiovascular consequences of aortic stenosis, less is known on how peripheral arterial stiffness relates to aortic valve disease. Previous studies have shown conflicting results regarding the impact of aortic valve replacement on arterial stiffness. The aim of the present study was therefore to determine predictors of arterial stiffness in patients with and without aortic valve disease undergoing cardiac surgery. Cardio ankle vascular index (CAVI) and carotid femoral pulse wave velocity (cfPWV) were measured to determine arterial stiffness the day before and 3 days after surgery for either ascending aortic or aortic valve disease. Stratification on indication for surgery revealed that CAVI was significantly lower in patients with aortic valve stenosis (n = 45) and aortic valve regurgitation (n=30) compared with those with isolated ascending aortic dilatation (n = 13). After surgery, a significant increased CAVI was observed in aortic stenosis (median 1.34, IQR 0.74–2.26, p < 0.001) and regurgitation (median 1.04, IQR 0.01–1.49, p = 0.003) patients while cfPWV was not significantly changed. Age, diabetes, low body mass index, low pre-operative CAVI, as well as changes in ejection time were independently associated with increased CAVI after surgery. The results of the present study suggest aortic valve disease as cause of underestimation of arterial stiffness when including peripheral segments. We report cardiovascular risk factors and pinpoint the hemodynamic aspect ejection time to be associated with increased CAVI after aortic valve surgery.

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Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Cardiovascular Risk Factors and Hemodynamic Measures as Determinants of Increased Arterial Stiffness Following Surgical Aortic Valve Replacement

Plunde

Franco‐Cereceda

Bäck

2021

Front. Cardiovasc. Med.

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“… 2 However, Zva cannot discriminate the valvular and arterial respective contribution, raising the notion that direct measurement of arterial stiffness would represent additional value in aortic stenosis evaluation. Indeed, increased measures of arterial stiffness have been associated with aortic valve calcium, 3 aortic valve sclerosis, 4 aortic stenosis 5 and poor prognosis after aortic valve replacement. 6 However, the effect of aortic valve replacement on arterial stiffness, although studied, remains to be clinched.…”

Section: The Importance Of Arterial Stiffness In Aortic Valve Stenosismentioning

confidence: 99%

Arterial Stiffness in Aortic Stenosis and the Impact of Aortic Valve Replacement

Plunde¹,

Bäck²

2022

VHRM

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The most common cause for interventional valve treatment is aortic stenosis. A cardinal symptom of aortic stenosis is heart failure due to the increased load exerted on the left ventricle. However, the left ventricular load is not solely determined based on the degree of aortic stenosis but is also impacted by arterial stiffness. The combined load can be determined by valvulo-arterial impedance (Zva), which is associated with poor outcome in aortic stenosis. We recently demonstrated low measures of systemic arterial stiffness in patients with aortic stenosis, and that arterial stiffness was increased after surgical aortic valve replacement. The results indicated a masked arterial stiffness in aortic stenosis when using methods incorporating peripheral arterial segments. Available studies using several different methods to assess arterial stiffness in relatively small aortic stenosis cohorts examined before and after either surgical or transcatheter aortic valve replacement/intervention have generated contradictory results. In this commentary, we present a detailed literature review to explore how different methods and measures of arterial stiffness in aortic stenosis capture or not, a masked arterial stiffness in aortic stenosis and possible reasons for the observed results. Future studies validating a non-invasive reproducible method to assess arterial stiffness in aortic stenosis patients could potentially lead to an implementation in pre-interventional risk assessment for aortic stenosis.

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“…Four studies [16,18,25,31] showed a significantly higher PWV in the 230 AVSc patients as without heterogeneity among studies (I 2 = 25.9%; p = 0.249). Of interest, after excluding the study by Erdogan et al [16], that enrolled non aged-matched cohorts, the lack of difference in AIx values between AVSc patients and controls was consistently confirmed (MD: 0.99 mm; 95%CI: -1.07, 3.06; p = 0.347, I 2 = 41,5%; p = 0.162).…”

Section: Pulse Wave Velocity (Pwv)mentioning

confidence: 99%

Markers of subclinical atherosclerosis in patients with aortic valve sclerosis: A meta-analysis of literature studies

Minno

Songia

et al. 2016

International Journal of Cardiology

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0.11, 1.81; p=0.027) were found in AVSc subjects than in controls, with no differences in AIx (MD: 0.76%; 95%CI: -0.97, 2.49; p=0.389). In Meta-regression analyses body mass index and triglycerides levels have an impact on the difference in IMT between cases and controls, while male gender and smoking habit were associated with the difference in the prevalence of CPs between the two groups. Conclusion:AVSc is significantly associated with altered markers of subclinical atherosclerosis, thus supporting the concept that AVSc and atherosclerosis share common etiopathological mechanism and/or risk factors. On this basis, an echocardiogram carried out to assess the state of the aortic valve would be desirable whenever an altered subclinical marker of atherosclerosis is found.

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Aortic valve sclerosis is a sign of increased arterial stiffness in clinically asymptomatic subjects

Cited by 9 publications

References 26 publications

Cardiovascular Risk Factors and Hemodynamic Measures as Determinants of Increased Arterial Stiffness Following Surgical Aortic Valve Replacement

Cardiovascular Risk Factors and Hemodynamic Measures as Determinants of Increased Arterial Stiffness Following Surgical Aortic Valve Replacement

Arterial Stiffness in Aortic Stenosis and the Impact of Aortic Valve Replacement

Markers of subclinical atherosclerosis in patients with aortic valve sclerosis: A meta-analysis of literature studies

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