Changes of vascular stiffness and central blood pressure after endovascular aneurysm repair in patients with hypertension. Results of one-year follow-up

Aim. To assess the changes of arterial stiffness, central blood pressure (CBP), and determine the factors potentially influencing them in patients with descending thoracic and abdominal aortic aneurysm, in combination with hypertension, one year after endovascular aneurysm repair ((T)EVAR).Material...

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Main Authors: A. P. Gurevich, I. V. Emelyanov, M. V. Ionov, A. G. Vanyurkin, M. A. Chernyavsky, A. O. Conradi
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2023-12-01
Series:Российский кардиологический журнал
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Online Access:https://russjcardiol.elpub.ru/jour/article/view/5645
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author A. P. Gurevich
I. V. Emelyanov
M. V. Ionov
A. G. Vanyurkin
M. A. Chernyavsky
A. O. Conradi
author_facet A. P. Gurevich
I. V. Emelyanov
M. V. Ionov
A. G. Vanyurkin
M. A. Chernyavsky
A. O. Conradi
author_sort A. P. Gurevich
collection DOAJ
description Aim. To assess the changes of arterial stiffness, central blood pressure (CBP), and determine the factors potentially influencing them in patients with descending thoracic and abdominal aortic aneurysm, in combination with hypertension, one year after endovascular aneurysm repair ((T)EVAR).Material and methods. Patients ≥18 years of age without clinically significant cardiac arrhythmias were included. Before surgery and a year later, we determined peripheral blood pressure, heart rate (HR), CBP, augmentation index (AIx), pressure at the point of maximum rise of the direct pulse wave (PT1h), time to return of the reflected pressure wave (Tr) and carotid femoral pulse wave velocity (cfPWV).Results. Fifty patients were included (mean age, 68±9 years; 41 men; 16 with descending thoracic aortic aneurysm, 34 with abdominal aortic aneurysm), 23 patients were reexamined. After (T)EVAR, an increase in cfPWV (+2,6 m/s, p<0,001), PT1h (+5 mm Hg, p=0,026), peripheral pulse pressure (+7 mm Hg, p=0,039), heart rate (+5 beats/min, p=0,025). The CBP and AIx values have not changed. The dependence of Tr decrease on the stent-graft length (β=0,42) and the decrease in heart rate (β=-0,52) was found. During the year, 6 cardiovascular events were registered.Conclusion. Graft implantation is accompanied by an increase in cfPWV, regardless of aneurysm location. An increase in PT1h one year after (T)EVAR may reflect a decrease in aortic distensibility and worsening damping function. No changes of CBP and AIx is probably explained by reflected wave characteristics after surgery. Predictors of Tr are — increase in heart rate and implantation of longer stent grafts.
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spelling doaj-art-636dd7e109e347a2b434939d590cbad22025-08-20T03:00:50Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202023-12-01281210.15829/1560-4071-2023-56453960Changes of vascular stiffness and central blood pressure after endovascular aneurysm repair in patients with hypertension. Results of one-year follow-upA. P. Gurevich0I. V. Emelyanov1M. V. Ionov2A. G. Vanyurkin3M. A. Chernyavsky4A. O. Conradi5Almazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterAim. To assess the changes of arterial stiffness, central blood pressure (CBP), and determine the factors potentially influencing them in patients with descending thoracic and abdominal aortic aneurysm, in combination with hypertension, one year after endovascular aneurysm repair ((T)EVAR).Material and methods. Patients ≥18 years of age without clinically significant cardiac arrhythmias were included. Before surgery and a year later, we determined peripheral blood pressure, heart rate (HR), CBP, augmentation index (AIx), pressure at the point of maximum rise of the direct pulse wave (PT1h), time to return of the reflected pressure wave (Tr) and carotid femoral pulse wave velocity (cfPWV).Results. Fifty patients were included (mean age, 68±9 years; 41 men; 16 with descending thoracic aortic aneurysm, 34 with abdominal aortic aneurysm), 23 patients were reexamined. After (T)EVAR, an increase in cfPWV (+2,6 m/s, p<0,001), PT1h (+5 mm Hg, p=0,026), peripheral pulse pressure (+7 mm Hg, p=0,039), heart rate (+5 beats/min, p=0,025). The CBP and AIx values have not changed. The dependence of Tr decrease on the stent-graft length (β=0,42) and the decrease in heart rate (β=-0,52) was found. During the year, 6 cardiovascular events were registered.Conclusion. Graft implantation is accompanied by an increase in cfPWV, regardless of aneurysm location. An increase in PT1h one year after (T)EVAR may reflect a decrease in aortic distensibility and worsening damping function. No changes of CBP and AIx is probably explained by reflected wave characteristics after surgery. Predictors of Tr are — increase in heart rate and implantation of longer stent grafts.https://russjcardiol.elpub.ru/jour/article/view/5645aortic aneurysmhypertensionvascular stiffnesspulse wave velocitycentral blood pressureendovascular aortic repair
spellingShingle A. P. Gurevich
I. V. Emelyanov
M. V. Ionov
A. G. Vanyurkin
M. A. Chernyavsky
A. O. Conradi
Changes of vascular stiffness and central blood pressure after endovascular aneurysm repair in patients with hypertension. Results of one-year follow-up
Российский кардиологический журнал
aortic aneurysm
hypertension
vascular stiffness
pulse wave velocity
central blood pressure
endovascular aortic repair
title Changes of vascular stiffness and central blood pressure after endovascular aneurysm repair in patients with hypertension. Results of one-year follow-up
title_full Changes of vascular stiffness and central blood pressure after endovascular aneurysm repair in patients with hypertension. Results of one-year follow-up
title_fullStr Changes of vascular stiffness and central blood pressure after endovascular aneurysm repair in patients with hypertension. Results of one-year follow-up
title_full_unstemmed Changes of vascular stiffness and central blood pressure after endovascular aneurysm repair in patients with hypertension. Results of one-year follow-up
title_short Changes of vascular stiffness and central blood pressure after endovascular aneurysm repair in patients with hypertension. Results of one-year follow-up
title_sort changes of vascular stiffness and central blood pressure after endovascular aneurysm repair in patients with hypertension results of one year follow up
topic aortic aneurysm
hypertension
vascular stiffness
pulse wave velocity
central blood pressure
endovascular aortic repair
url https://russjcardiol.elpub.ru/jour/article/view/5645
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