SPC365

Aortic stenosis: much more than an isolated heart disease

Session: Posters - G. Aortic Disease, Peripheral Vascular Disease, Stroke
Speaker: Sofia S. Martinho

Congress: CPC 2021
Topic: G. Aortic Disease, Peripheral Vascular Disease, Stroke
Theme: 22. Aortic Disease
Subtheme: 22.1 Aortic Disease – Pathophysiology and Mechanisms
Session Type: Posters
FP Number: ---
Authors: Sofia S. Martinho; José Almeida; Cátia Ferreira; Valdirene Gonçalves; André Freitas; João André Ferreira; Gustavo Campos; João Rosa; Fátima Franco; Rogerio Teixeira; Lino Gonçalves

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">BACKGROUND:</span></span></span><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> A<span style="background-color:white"><span style="color:#212121">ortic stenosis (AS) is more than only a degenerative disease; it could be also an atherosclerotic-like process involving the valve instead of the vessels. Little is known about the relation of arterial stiffness pre- and post-aortic valvular replacement. </span></span></span></span><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">We aimed to</span></span><span style="font-size:10.0pt"><span style="background-color:white"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black"> assess the improvement of vascular component properties after aortic valve replacement in patients with severe aortic stenosis.</span></span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">METHODS</span></span></span><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">: We conducted a retrospective, observational study of 50 patients with previous diagnosis of severe aortic stenosis, submitted to surgical or percutaneous valve replacement between 2011 and 2017. </span></span><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">All underwent a comprehensive echocardiography, at baseline and 1-year after valvular replacement with evaluation of <span style="background-color:white"><span style="color:black">aortic strain, distensibility, stiffness index (&beta;) and </span></span>valvuloarterial impedance (Zva).</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">RESULTS: Mean age was </span></span><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">79&plusmn;3 years and 58% were male. At baseline, 88% were on NYHA II and 12% in NYHA III-IV functional class; mean LVEF 61&plusmn;7%, mean transvalvular gradient 50&plusmn;12mmHg with a mean stroke volume indexed (SVi) of 49&plusmn;6mL/m<sup>2</sup>.</span></span><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> Most of the patient were submitted to surgical replacement (n=48). <span style="color:black">Functional class improved significantly, 1-year after valve replacement, most patients were in in NYHA I (76%), p&lt;0.001. </span><span style="color:black">Regarding echocardiography data, we found a significant </span><span style="color:black">decrease in the </span></span></span><span style="font-size:10.0pt"><span style="background-color:white"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">&beta; stiffness and </span></span></span></span><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Zva indexes, from 8.8&plusmn;7.2 to 5.6&plusmn;4.1, -3.2&plusmn;8.1 <span style="color:black">(95%CI -5.7 to -0,6, p=0.015) </span>and from 4.2&plusmn;1.2 to 3.7&plusmn;0.8<span style="background-color:white"><span style="color:#2a2a2a"> mmHg/mL/m&sup2;</span></span>, -0.6&plusmn;1.7<span style="background-color:white"><span style="color:#2a2a2a"> mmHg/mL/m&sup2;</span></span> <span style="color:black">(95%CI -1.1 to -0.1</span><span style="background-color:white"><span style="color:#2a2a2a"> mmHg/mL/m&sup2;</span></span><span style="color:black">, p=0.029), </span>respectively. <span style="color:black">We also identified</span> a numeric improvement in <span style="background-color:white"><span style="color:black">aortic strain and distensibility, but without statistical difference [</span></span>2.1&plusmn;8.8% <span style="color:black">(95%CI -0.8 to 5%, p=0.132) </span>and (0.2&plusmn;4.2) x10<sup>-3</sup> mmHg<sup>-1</sup> <span style="color:black">(95%CI (-</span>0.2 to 1.6) x10<sup>-3 </sup>mmHg<sup>-1</sup><span style="color:black">, p=0.77), respectively].</span></span></span></span></span></p>

<p><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">CONCLUSIONS: According to our data, an aortic valve intervention also improved the vascular load of aortic stenosis patients.</span></span></span></p>