Valvular & structural heart disease
The effect of increased vascular afterload measures on flow rate and survival in severe aortic stenosis
Authors' conclusion
Elevated vascular afterload measures and comorbidities linked to arteriosclerosis and/or degenerative aortic stiffening independently reduce flow rates in severe AS. A TFR ≤ 210 mL/s predicts mortality but improves with BP assessment during evaluation.
Study context
- Population
- Patients ≥ 65 years with severe aortic stenosis (AS) (aortic valve area ≤ 1 cm²) who underwent transcatheter aortic valve replacement over a 5-year periodprospective 110 · registry analysis 213
- Participants
- 323 patients
- Exposure
- Relationship between blood pressure (BP), vascular afterload measures, clinical history of hypertension, transaortic flow rate (TFR), and survival
- Outcome
- Association of vascular afterload measures with TFR (linear regression)
Main finding
As reported in the abstract
- Higher systolic BP
- ß −0.545; P = 0.01†
- Pulse pressure
- ß −0.545; P = 0.01†
- Vascular resistance
- ß −0.02; P = 0.041
- Characteristic impedance
- ß −0.27; P = 0.01
- Lower arterial compliance
- ß 32.73; P < 0.001†
Observational data: associations, not effects.
Further findings
| Outcome | History of hypertension | No history of hypertension |
|---|---|---|
| TFR by history of hypertension (registry analysis) | 223 ± 67 mL/s | 244 ± 77 mL/s |
- TFR by history of hypertension (registry analysis) — r
- −0.138; P = 0.045
TFR lower with coronary artery disease (CAD), dialysis dependency, increased anti-hypertensive medication use (registry analysis)
- Coronary artery disease (CAD)
- P < 0.01
- Dialysis dependency
- P < 0.01
- Increased anti-hypertensive medication use
- P = 0.04
- CAD in linear regression
- ß −28.5; P = 0.08†
- Dialysis dependency in linear regression
- ß −68.5; P = 0.04†
- † denotes adjusted
Mortality by TFR ≤ 210 mL/s in normotensive patients
- Strongest predictor of mortality
- 73.3% vs. 86.7%; P = 0.043
Original publication
The effect of increased vascular afterload measures on flow rate and survival in severe aortic stenosis. Eur Heart J Cardiovasc Imaging. Published 23 January 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →