Thoracic endografting increases cardiac afterload and leads to left ventricular hypertrophy in dogs

Yamashita, Yoshiyuki; Oishi, Yoshifumi; Motomatsu, Yuma; Hirayama, Kazuto; Harada, Takeaki; Ushijima, Tatsuo; Fujita, Satoshi; Kimura, Satoshi; Sonoda, Hiromichi; Tatewaki, Hideki; Tanoue, Yoshihisa; Sunagawa, Genya; Nishikawa, Takuya; Saku, Keita; Shiose, Akira

doi:10.1093/ejcts/ezy402

Cited by 8 publications

(8 citation statements)

References 27 publications

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“…We assessed Z0 and Zc. Z0, which is calculated from the Fourier transform of the ascending aortic pressure and flow waveforms, represents LV afterload 19 . Zc is the ratio of pulsatile pressure to pulsatile flow in the absence of wave reflections and is attributed to proximal aortic wall stiffness and radius 20 .…”

Section: Stent-graftingmentioning

confidence: 99%

Reflected wave intensity increases based on aortic diameter after endovascular aortic therapy in a goat model

Takano

Iwai-Takano

Tsuboko

et al. 2021

Sci Rep

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Reflected wave increases after endovascular aortic repair (EVAR) in patients with aortic aneurysm. This affects the left ventricular (LV) diastolic function and leads to a poor prognosis. This study aimed to evaluate the relationship between increased reflected wave amplitude and aortic diameter after EVAR. EVAR was performed in seven healthy goats. We assessed wave intensity (WI), aortic diameter, and stiffness parameter β. Moreover, we evaluated the relationship between negative reflected wave (NW, reflected waves toward the heart from the periphery by WI) and other parameters after EVAR. Results showed an increase in stiffness parameter β (3.5 ± 0.3 vs 15.9 ± 4.7, p = 0.018) and a decrease in the change of aortic diameter (6.9 ± 0.7 vs 2.7 ± 0.4%, p = 0.018) after EVAR. The NW was significantly amplified after EVAR from baseline (−589.8 ± 143.4 to − 1192.3 ± 303.7 mmHg-m/sec3, p = 0.043). The NW showed a significant correlation with maximum aortic diameter (R = 0.707, p = 0.038) and minimum aortic diameter (R = 0.724, p = 0.033). The reflected wave was enhanced after EVAR and was correlated to the aortic diameter at the stent-graft site. It is important to consider that patients with smaller aortic diameters in landing zone who undergo EVAR may develop LV dysfunction.

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Section: Stent-graftingmentioning

confidence: 99%

Reflected wave intensity increases based on aortic diameter after endovascular aortic therapy in a goat model

Takano

Iwai-Takano

Tsuboko

et al. 2021

Sci Rep

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“…such as those with chronic heart failure. However, TEVAR has been shown to increase aortic stiffness in animal models 1,2 and can potentially lead to decompensated heart failure. By means of exercise echocardiography, Hiraoka and colleagues 3 found higher afterload in patients following TEVAR compared with patients who did not undergo TE-VAR.…”

Section: Central Messagementioning

confidence: 99%

“…Thoracic endovascular aortic repair (TEVAR) has been extensively applied to those patients with a life-threatening aneurysm who have inferior tolerance to open surgery, such as those with chronic heart failure. However, TEVAR has been shown to increase aortic stiffness in animal models 1 , 2 and can potentially lead to decompensated heart failure. By means of exercise echocardiography, Hiraoka and colleagues 3 found higher afterload in patients following TEVAR compared with patients who did not undergo TEVAR.…”

mentioning

confidence: 99%

A simplified assessment of increased afterload by thoracic endovascular aortic repair

Orihashi¹

2020

JTCVS Techniques

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Video clip is available online. Thoracic endovascular aortic repair (TEVAR) has been extensively applied to those patients with a life-threatening aneurysm who have inferior tolerance to open surgery, paired corresponding waveforms traced, vertical scale and time scale adjusted, and each parameter measured flow velocity pressure tracing 100 peak P peak V V dt ΔP 0 0 FIGURE 1. Method of data collection and parameters. The pressure and flow velocity were recorded simultaneously via a catheter for angiography and with transesophageal echocardiography. Pairs of corresponding waveforms were traced, and each parameter was measured (see also Video 1). TEE, Transesophageal echocardiography.

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“…What we do know is that reinterventions after FET are common if not inevitable (13) and what we begin to understand is the effect of the stiffness of an endoprothesis with regard to worsening heart function (14,15) and with costs which are considerable. It is interesting to note that that de NICE draft Guideline in the UK suggested that patients with abdominal aortic aneurysms should not be offered endovascular repair if open surgical repair is feasible, although this draft is still under consultation.…”

mentioning

confidence: 99%

Classical Elephant Trunk—old fashioned thus obsolete?

Morshuis¹

2023

J Vis Surg

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Thoracic endografting increases cardiac afterload and leads to left ventricular hypertrophy in dogs

Cited by 8 publications

References 27 publications

Reflected wave intensity increases based on aortic diameter after endovascular aortic therapy in a goat model

Reflected wave intensity increases based on aortic diameter after endovascular aortic therapy in a goat model

A simplified assessment of increased afterload by thoracic endovascular aortic repair

Classical Elephant Trunk—old fashioned thus obsolete?

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