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Effect of endoprostheses on pulse wave velocity and its long-term outcomes after thoracic endovascular aortic repair

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Abstract

Background

The purpose of this study was to evaluate the changes in pulse wave velocity and left ventricular dimensions in patients undergoing stent-graft treatment for aortic arch aneurysm.

Methods

From July 2008 to February 2019, 86 patients underwent thoracic endovascular aortic repair of an aortic arch aneurysm. Changes in pulse wave velocity (PWV), echocardiogram findings, and long-term outcomes were compared between endoskeleton type (n = 60) and exoskeleton type stent-graft (n = 26).

Results

There was no significant difference in patient demographics except for diabetes which was more observed in endoskeleton type (p = 0.017). There was a significant increase in PWV in exoskeleton type after surgery, which further progressed at a median follow-up of 32 months (before: 2047 cm/s vs. after: 2259 cm/s vs. follow-up: 2486 cm/s, p = 0.010, p = 0.017). No significant difference was observed in endoskeleton type (before: 1980 cm/s vs. after: 2058 cm/s, vs. follow-up: 2042 cm/s, p = 0.25, p = 0.34). Echocardiogram performed at a median period of 46.3 months, revealed a significant increase in left ventricular diastolic volume (LVDV) (before: 107.4 ± 20.6 ml vs. follow-up: 127.7 ± 27.5 ml, p = 0.003) and decrease in e′ (before: 5.5 ± 1.78 cm/s vs. follow-up: 4.7 ± 1.72 cm/s, p = 0.012) in exoskeleton type, while no significant change was observed in endoskeleton type (LVDV: before: 102.6 ± 32.3 ml vs. follow-up: 96.9 ± 35.4 ml, p = 0.74; e′: before: 4.4 ± 1.21 cm/s vs. follow-up: 4.8 ± 1.40 cm/s, p = 0.68). At the median period of 61.3 months, there was no significant difference in long-term mortality (p = 0.89). However, the endoskeleton type was associated with a lower incidence of a cardiac event (p = 0.034) and cerebrovascular event (p = 0.029).

Conclusion

Types of endoprosthesis might affect differently on physiological changes and its accommodated risk factors after surgery.

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References

  1. Hori D, Okamura H, Yamamoto T, Nishi S, Yuri K, Kimura N, et al. Early and mid-term outcomes of endovascular and open surgical repair of non-dissected aortic arch aneurysm. Interact Cardiovasc Thorac Surg. 2017;24(6):944–50.

    Article  PubMed  Google Scholar 

  2. Maroules CD, Khera A, Ayers C, Goel A, Peshock RM, Abbara S, et al. Cardiovascular outcome associations among cardiovascular magnetic resonance measures of arterial stiffness: the Dallas heart study. J Cardiovasc Magn Reson. 2014;16:33.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Mattace-Raso FU, van der Cammen TJ, Hofman A, van Popele NM, Bos ML, Schalekamp MA, et al. Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam study. Circulation. 2006;113(5):657–63.

    Article  PubMed  Google Scholar 

  4. Ohkuma T, Ninomiya T, Tomiyama H, Kario K, Hoshide S, Kita Y, et al. Brachial-ankle pulse wave velocity and the risk prediction of cardiovascular disease: an individual participant data meta-analysis. Hypertension. 2017;69(6):1045–52.

    Article  CAS  PubMed  Google Scholar 

  5. Sutton-Tyrrell K, Najjar SS, Boudreau RM, Venkitachalam L, Kupelian V, Simonsick EM, et al. Elevated aortic pulse wave velocity, a marker of arterial stiffness, predicts cardiovascular events in well-functioning older adults. Circulation. 2005;111(25):3384–90.

    Article  PubMed  Google Scholar 

  6. Spadaccio C, Nappi F, Al-Attar N, Sutherland FW, Acar C, Nenna A, et al. Old myths, new concerns: the long-term effects of ascending aorta replacement with dacron grafts. Not all that glitters is gold. J Cardiovasc Transl Res. 2016;9(4):334–42.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Hori D, Akiyoshi K, Yuri K, Nishi S, Nonaka T, Yamamoto T, et al. Effect of endoskeleton stent graft design on pulse wave velocity in patients undergoing endovascular repair of the aortic arch. Gen Thorac Cardiovasc Surg. 2017;65(9):506–11.

    Article  PubMed  Google Scholar 

  8. Munakata M. Brachial-ankle pulse wave velocity: background, method, and clinical evidence. Pulse. 2016;3(3–4):195–204.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kanzaki H. Aortic compliance and left ventricular diastolic function. Do endovascular repairs for aortic aneurysm alter aortic stiffness? Circ J. 2014;78(2):307–8.

    Article  PubMed  Google Scholar 

  10. Janic M, Lunder M, Sabovic M. Arterial stiffness and cardiovascular therapy. Biomed Res Int. 2014;2014:621437.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Nakamura T, Uematsu M, Deyama J, Watanabe Y, Nakamura K, Kobayashi T, et al. Pulmonary vascular resistance is associated with brachial-ankle pulse-wave velocity and adverse clinical outcomes in patients with heart failure with preserved ejection fraction. J Card Fail. 2019;25(9):725–32.

    Article  PubMed  Google Scholar 

  12. Saji N, Murotani K, Shimizu H, Uehara T, Kita Y, Toba K, et al. Increased pulse wave velocity in patients with acute lacunar infarction doubled the risk of future ischemic stroke. Hypertens Res. 2017;40(4):371–5.

    Article  PubMed  Google Scholar 

  13. Seo WK, Lee JM, Park MH, Park KW, Lee DH. Cerebral microbleeds are independently associated with arterial stiffness in stroke patients. Cerebrovasc Dis. 2008;26(6):618–23.

    Article  PubMed  Google Scholar 

  14. Takeda Y, Sakata Y, Ohtani T, Tamaki S, Omori Y, Tsukamoto Y, et al. Endovascular aortic repair increases vascular stiffness and alters cardiac structure and function. Circ J. 2014;78(2):322–8.

    Article  PubMed  Google Scholar 

  15. Tokitsu T, Yamamoto E, Oike F, Hirata Y, Tsujita K, Yamamuro M, et al. Clinical significance of brachial-ankle pulse-wave velocity in patients with heart failure with preserved left ventricular ejection fraction. J Hypertens. 2018;36(3):560–8.

    Article  CAS  PubMed  Google Scholar 

  16. Tomiyama H, Matsumoto C, Shiina K, Yamashina A. Brachial-ankle PWV: current status and future directions as a useful marker in the management of cardiovascular disease and/or cardiovascular risk factors. J Atheroscler Thromb. 2016;23(2):128–46.

    Article  CAS  PubMed  Google Scholar 

  17. Wang CP, Hung WC, Yu TH, Hsu HL, Chen YH, Chiu CA, et al. Brachial-ankle pulse wave velocity as an early indicator of left ventricular diastolic function among hypertensive subjects. Clin Exp Hypertens. 2009;31(1):31–433.

    Article  PubMed  Google Scholar 

  18. Papadopoulos G, Kontopodis N, Marketou ME, Patrianakos A, Lioudaki S, Parthenakis FI, et al. Analysis of echocardiographic markers and pulse wave velocities in a patient who developed new cardiac symptoms after implantation of an aortic endograft. Ann Vasc Surg. 2019;58:381–e11.

    Article  PubMed  Google Scholar 

  19. Kadoglou NP, Moulakakis KG, Papadakis I, Ikonomidis I, Alepaki M, Lekakis J, et al. Changes in aortic pulse wave velocity of patients undergoing endovascular repair of abdominal aortic aneurysms. J Endovasc Ther. 2012;19(5):661–6.

    Article  PubMed  Google Scholar 

  20. Moulakakis KG, Kadoglou NPE, Antonopoulos CN, Mylonas SN, Kakisis J, Papadakis I, et al. Changes in arterial stiffness and N-terminal pro-brain natriuretic peptide levels after endovascular repair of descending thoracic aorta. Ann Vasc Surg. 2017;38:220–6.

    Article  PubMed  Google Scholar 

  21. van Noort K, Holewijn S, Schuurmann RCL, Boersen JT, Overeem SP, Jebbink EG, et al. Effect of abdominal aortic endoprostheses on arterial pulse wave velocity in an in vitro abdominal aortic flow model. Physiol Meas. 2018;39(10):104001.

    Article  PubMed  Google Scholar 

  22. Ioannou CV, Morel DR, Katsamouris AN, Katranitsa S, Startchik I, Kalangos A, et al. Left ventricular hypertrophy induced by reduced aortic compliance. J Vasc Res. 2009;46(5):417–25.

    Article  PubMed  Google Scholar 

  23. Yuri K, Yokoi Y, Yamaguchi A, Hori D, Adachi K, Adachi H. Usefulness of fenestrated stent grafts for thoracic aortic aneurysms. Eur J Cardiothorac Surg. 2013;44(4):760–7.

    Article  PubMed  Google Scholar 

  24. Kadoglou NP, Moulakakis KG, Papadakis I, Ikonomidis I, Alepaki M, Spathis A, et al. Differential effects of stent-graft fabrics on arterial stiffness in patients undergoing endovascular aneurysm repair. J Endovasc Ther. 2014;21(6):850–8.

    Article  PubMed  Google Scholar 

  25. Hori D, Nomura Y, Yamauchi T, Furuhata H, Matsumoto H, Kimura N, et al. Perioperative factors associated with aneurysm sac size changes after endovascular aneurysm repair. Surg Today. 2019;49(2):130–6.

    Article  CAS  PubMed  Google Scholar 

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Funding

This study was supported by Jichi Medical University Young Investigator Award (2018).

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya-ku, Saitama, Saitama, 330-8503, Japan

    Daijiro Hori, Koichi Yuri, Sho Kusadokoro, Toshikazu Shimizu, Naoyuki Kimura & Atsushi Yamaguchi

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  1. Daijiro Hori
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  2. Koichi Yuri
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  3. Sho Kusadokoro
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  4. Toshikazu Shimizu
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  5. Naoyuki Kimura
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  6. Atsushi Yamaguchi
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Correspondence to Daijiro Hori.

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Hori, D., Yuri, K., Kusadokoro, S. et al. Effect of endoprostheses on pulse wave velocity and its long-term outcomes after thoracic endovascular aortic repair. Gen Thorac Cardiovasc Surg 68, 1134–1141 (2020). https://doi.org/10.1007/s11748-020-01343-0

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  • DOI: https://doi.org/10.1007/s11748-020-01343-0

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