Determinants of Changes in Arterial Stiffness after Thoracic Endovascular Aortic Repair
| Autor: | Tomoki Ushijima, Hiromichi Sonoda, Sho Matsuyama, Satoshi Fujita, Yoshiyuki Yamashita, Satoshi Kimura, Yoshihisa Tanoue, Yasuhisa Oishi, Akira Shiose |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Aorta Thoracic Pulse Wave Analysis Coronary artery disease Blood Vessel Prosthesis Implantation Aortic aneurysm Vascular Stiffness Risk Factors Internal medicine medicine Humans Pulse wave velocity Aged Retrospective Studies Aged 80 and over Aortic dissection Aortic Aneurysm Thoracic business.industry Endovascular Procedures General Medicine Odds ratio Middle Aged medicine.disease Confidence interval Blood Vessel Prosthesis Aortic Dissection Treatment Outcome Blood pressure cardiovascular system Arterial stiffness Cardiology Female Stents Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | Annals of Vascular Surgery. 70:474-480 |
| ISSN: | 0890-5096 |
| Popis: | Objective Aortic stent grafting can cause aortic stiffening and increase pulse wave velocity (PWV), which can potentially affect long-term cardiovascular outcomes. The aim of this study was to clarify the factors contributing to increases in PWV after thoracic endovascular aortic repair (TEVAR). Methods We included 64 patients with thoracic aortic pathology (51 men; mean age: 73 years) who underwent elective TEVAR, in this study. TEVAR was performed for degenerative aortic aneurysm (n=43) or aortic dissection (n=21), and the treatment length was 175 ± 52 mm. Brachial–ankle PWV (baPWV) was obtained before and 1 week after TEVAR. Univariable and multivariable logistic regression analyses were used to determine the predictors of increases in baPWV of ≥ 100 cm/s following TEVAR. Results baPWV increased from 1851 ± 392 cm/s to 2047 ± 479 cm/s, and the change in baPWV (ΔbaPWV) was 195 ± 339 cm/s (95% confidence interval: 111–280). Thirty-seven patients (58%) had ΔbaPWV ≥ 100 cm/s following TEVAR. In the multivariable analysis, in addition to Δheart rate and Δsystolic blood pressure, age (odds ratio: 1.21/year, 95% confidence interval: 1.05–1.40) and coronary artery disease (odds ratio: 12.0, 95% confidence interval: 1.20–121) were independent determinants of ΔbaPWV ≥ 100 cm/s following TEVAR, whereas ΔbaPWV ≥ 100 cm/s was not associated with treatment length or device type. Conclusions TEVAR was associated with PWV progression, especially in older patients with coronary artery disease, whereas treatment length or device type was not a predictor of PWV progression following TEVAR. |
| Databáze: | OpenAIRE |
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