Heart failure & cardiomyopathies
Endovascular Treatment of Flow-Limiting Iliofemoral Stenosis Improves Left Ventricular Diastolic Function in Patients With HFpEF by Reducing Aortic Pulsatile Load
Authors' conclusion
Endovascular treatment of flow-limiting iliofemoral stenosis reduces aortic pulsatile load and concurrently lowers total peripheral resistance. This beneficial effect is associated with an acute and sustained improvement of left ventricular diastolic function.
Study context
- Population
- Patients with symptomatic PAD and HFpEF (Heart Failure Association-preserved ejection fraction score) scheduled for endovascular treatment (EVT) or angiography
- Participants
- 30 patients
- Exposure
- EVT vs angiography
- EVTn = 25
- Controln = 5reference
- Outcome
- LV diastolic function (echocardiography)
- Follow-up
- Day after EVT and 4 months
Methodological detailsnon-randomised control (angiography only)
- Non-randomised control (angiography only)
Main finding
As reported in the abstract
LV diastolic function · acutely and at follow-up
- Left ventricular (LV) diastolic function improved after EVT vs control, acutely and at follow-up: increased septal and lateral e´ velocities, decreased E/e´ and left atrial volume index
Observational data: associations, not effects.
Further findings
Peripheral hemodynamics
- After EVT, decreased total peripheral resistance and increased common femoral artery flow and ankle brachial index (significant)
Aortic function and aortic pulsatile load · immediately and at follow-up
- After EVT, significantly reduced augmentation index and pulse wave velocity and increased compliance, with reduced aortic pulsatile load (characteristic impedance of proximal aorta and reflection coefficient)
LV mass index and LV mean wall thickness · follow-up
- Decreased at follow-up
NYHA class and treadmill walking distance · follow-up
- Improved post-EVT at follow-up
Determinants of E/e´
- Augmentation index, pulse wave velocity and arterial compliance were independent contributors to E/e´
Original publication
Endovascular Treatment of Flow-Limiting Iliofemoral Stenosis Improves Left Ventricular Diastolic Function in Patients With HFpEF by Reducing Aortic Pulsatile Load. Circ Heart Fail. Published 9 September 2024. doi:10.
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