Reduced cerebral vasoreactivity in severe aortic stenosis

Ščurić, Ivica; Lovrenčić-Huzjan, Arijana; Baborski, Franjo; Cerovec, Duško; Korda, Zvonimir Ante; Predrijevac, Mladen

doi:10.1093/eurheartj/eht309.p3969

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“…While the chronology of the compensatory mechanisms in brain haemodynamics triggered by AS is unknown, our patients were evaluated 6 months after SAVR, so long‐term effects on dCA and VR might yet be reverting at the moment of the post‐operative visit. In contrast to dCA, baseline brain vasoreactivity to CO 2 was impaired in AS patients, which accords with previous studies where a lower breath‐holding index was found in this subgroup (Scuric et al., 2013 ). When ejection fraction is reduced, Georgiadis ( 2000 ) demonstrated a restriction in the recruitment of cerebrovascular reactive dilatory capacity.…”

Section: Discussionsupporting

confidence: 91%

Changes in cerebral autoregulation and vasoreactivity after surgical aortic valve replacement: a prospective study

Pedro

Costa

Ferreira

et al. 2022

Experimental Physiology

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Surgical aortic valve replacement (SAVR) alters the natural course of severe aortic stenosis (AS). In this study, we aimed to determine the effects of the disease on dynamic cerebral autoregulation and vasoreactivity (VR) and to assess their changes after SAVR. We recruited 23 patients diagnosed with severe AS eligible for SAVR and 15 healthy matched controls. AS patients had lower mean VR to CO 2 (P = 0.005) than controls, but dynamic cerebral autoregulation was preserved.Cerebral haemodynamics showed no significant change after SAVR. Patients with smaller baseline aortic valve areas presented with smaller low frequency phase changes after surgery (P = 0.016). Severe AS does not seem to impact dynamic cerebral autoregulation but does reduce VR to CO 2 . SAVR does not alter cerebral autoregulation nor vasoreactivity.

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Section: Discussionsupporting

confidence: 91%