Impact of surgical aortic valve replacement and transcatheter aortic valve implantation on cardiovascular and cerebrovascular controls: A pilot study.
Vlasta BariFrancesca GelpiBeatrice CairoMartina AnguissolaElena AcerbiMattia SquillaceBeatrice De MariaEnrico Giuseppe BertoldoValentina FioloEdward CallusCarlo De VincentiisFrancesco BedogniMarco RanucciAlberto PortaPublished in: Physiological reports (2024)
Surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) are options in severe aortic valve stenosis (AVS). Cardiovascular (CV) and cerebrovascular (CBV) control markers, derived from variability of heart period, systolic arterial pressure, mean cerebral blood velocity and mean arterial pressure, were acquired in 19 AVS patients (age: 76.8 ± 3.1 yrs, eight males) scheduled for SAVR and in 19 AVS patients (age: 79.9 + 6.5 yrs, 11 males) scheduled for TAVI before (PRE) and after intervention (POST, <7 days). Left ventricular function was preserved in both groups. Patients were studied at supine resting (REST) and during active standing (STAND). We found that: (i) both SAVR and TAVI groups featured a weak pre-procedure CV control; (ii) TAVI ensured better CV control; (iii) cerebral autoregulation was working in PRE in both SAVR and TAVI groups; (iv) SAVR and TAVI had no impact on the CBV control; (v) regardless of group, CV and CBV control markers were not influenced by STAND in POST. Even though the post-procedure preservation of both CV and CBV controls in TAVI group might lead to privilege this procedure in patients at higher risk, the missing response to STAND suggests that this advantage could be insignificant.
Keyphrases
- transcatheter aortic valve implantation
- aortic valve replacement
- aortic valve
- aortic stenosis
- ejection fraction
- transcatheter aortic valve replacement
- left ventricular
- end stage renal disease
- newly diagnosed
- heart failure
- chronic kidney disease
- randomized controlled trial
- blood pressure
- peritoneal dialysis
- minimally invasive
- early onset
- subarachnoid hemorrhage
- heart rate variability
- mitral valve
- heart rate
- acute myocardial infarction
- hypertrophic cardiomyopathy
- cerebral ischemia
- cardiac resynchronization therapy
- blood brain barrier