Arterial stiffness & autonomic dysfunction in Aortic Stenosis.

• Research type

  Research Study

• Full title

  Importance of arterial stiffness and autonomic dysfunction in the pathophysiology of severe aortic stenosis

• IRAS ID

  211007

• Contact name

  Ana Rita Cabaco

• Contact email

  acabaco@nhs.net

• Sponsor organisation

  King’s College Hospital NHS Foundation Trust

• Duration of Study in the UK

  4 years, 0 months, 1 days

• Research summary

  Research summary:
  Aortic stenosis (narrowing) is a degenerative valve disease, meaning that the valve becomes narrowed throughout the years. Once it becomes very narrowed the only treatment is to replace the valve. How well patients respond to this treatment may be dependent on other conditions or diseases that they may have. This research project aims to identify if the stiffness of blood vessels and the way the nervous system behaves has any impact on the outcome of aortic valve treatment.

  Results Summary:
  I) Doppler-ultrasound consecutive and simultaneous measurement of pulse wave velocity (PWV) have a good agreement with gold standard carotid-femoral pulse wave velocity method.
  II) Age played the most significant role in the relationship between transmural pressure and aortic pulse wave velocity. The response of aoPWV to alternated changes in transmural pressure revealed three different patterns.
  III) There was no correlation between arterial stiffness, autonomic dysfunction, symptoms at presentation and clinical outcomes in our studies. These results should be interpreted with caution as the COVID-19 pandemic affected recruitment, compliance and follow up adherence.
  IV) First-phase of ejection fraction was not a significant predictor of all-cause mortality

  Conclusion:
  Doppler ultrasound serves as a simple method for measuring aortic pulse wave velocity, yet the alternating pressure dependency of aortic pulse wave velocity unveils inconsistent patterns.

  Notably, autonomic dysfunction and increased arterial stiffness are prevalent findings in severe aortic stenosis.
  Furthermore, it's noteworthy that the first-phase of ejection fraction failed to predict all- cause mortality in patients with symptomatic severe aortic stenosis who underwent aortic valve replacement.
  These findings are hypothesis-generating and lay the groundwork for future research in this area.

• REC name

  West of Scotland REC 3

• REC reference

  16/WS/0191

• Date of REC Opinion

  22 Dec 2016

• REC opinion

  Further Information Favourable Opinion