Endovascular Aortic Repair Increases Vascular Stiffness and Alters Cardiac Structure and Function
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概要
- 論文の詳細を見る
Background: Endovascular aortic repair (EVAR) is performed in patients with thoracic or abdominal aortic aneurysm because it is less invasive than conventional open repair. However, the effects of EVAR on vascular and cardiac function remain to be clarified. Methods and Results: We studied the effects of EVAR on several outcome variables in 40 consecutive patients undergoing EVAR for abdominal and/or thoracic aneurysm with preserved ejection fraction. Echocardiography and brachial–ankle pulse wave velocity (baPWV) data were collected before, 1 week, and 1 year after EVAR. Although no changes in blood pressure were found, baPWV, left ventricular mass index (LVMI), and left atrial volume index were significantly elevated at both post-op time periods after EVAR compared with baseline data. The changes in LVMI correlated with those in baPWV (R=0.32, P<0.05). Among the 22 patients who were successfully followed up, 13 showed deterioration in exercise tolerance 1 year after EVAR. Diastolic wall strain, an index for LV distensibility, was lower at baseline in patients with worsening exercise tolerance than in those with unchanged tolerance. Conclusions: EVAR increased vascular stiffness and induced LV hypertrophy and diastolic dysfunction without a corresponding elevation of blood pressure in the acute and chronic phases. In addition, low LV distensibility at baseline was associated with the impairment of exercise tolerance. EVAR-induced stiffness of arteries leads to limited clinical symptoms.
- 一般社団法人 日本循環器学会の論文
著者
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Mano Toshiaki
Department Of Cardiovascular Medicine Osaka University Graduate School Of Medicine
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Sakata Yasushi
Department Of Cardiovascular Medicine Osaka University Graduate School Of Medicine
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Omori Yosuke
Department of Cardiology, Osaka University
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Tamaki Shunsuke
Department of Cardiology, Osaka University
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Ohtani Tomohito
Department Of Cardiovascular Medicine Osaka University Graduate School Of Medicine
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Tsukamoto Yasumasa
Department Of Applied Physics Osaka University
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Takeda Yasuharu
Department Of Cardiology Osaka University Graduate School Of Medicine
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Sawa Yoshiki
Cardiovascular Medicine Osaka University Graduate School Of Medicine
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Komuro Issei
Department Of Cardiovascular Medicine
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Yamamoto Kazuhiro
Department of Biochemistry, Kinki University
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Aizawa Yoshihiro
Department of Cardiology, Nihon University, School of Medicine
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Komuro Issei
Departments of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Shimamura Kazuo
Cardiovascular Surgery, Osaka University Graduate School of Medicine
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Shirakawa Yukitoshi
Cardiovascular Surgery, Osaka University Graduate School of Medicine
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Kuratani Toru
Cardiovascular Surgery, Osaka University Graduate School of Medicine
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Sawa Yoshiki
Cardiovascular Surgery, Osaka University Graduate School of Medicine
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Tsukamoto Yasumasa
Departments of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Sakata Yasushi
Department of Applied Chemistry, Faculty of Engineering, Doshisha University
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Omori Yosuke
Departments of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Tamaki Shunsuke
Departments of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Mano Toshiaki
Departments of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Takeda Yasuharu
Departments of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Ohtani Tomohito
Departments of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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