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Improvement in Vascular Endothelial Function following Transcatheter Aortic Valve Implantation

Background and objectives: Endothelial dysfunction is associated with exercise intolerance and adverse cardiovascular events. Transcatheter aortic valve implantation (TAVI) is applied to treat elderly patients with severe aortic stenosis, but less is known about the impact of TAVI on endothelial dys...

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Autores principales: Tanaka, Shuhei, Imamura, Teruhiko, Ushijima, Ryuichi, Sobajima, Mitsuo, Fukuda, Nobuyuki, Ueno, Hiroshi, Hirai, Tadakazu, Kinugawa, Koichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539962/
https://www.ncbi.nlm.nih.gov/pubmed/34684045
http://dx.doi.org/10.3390/medicina57101008
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author Tanaka, Shuhei
Imamura, Teruhiko
Ushijima, Ryuichi
Sobajima, Mitsuo
Fukuda, Nobuyuki
Ueno, Hiroshi
Hirai, Tadakazu
Kinugawa, Koichiro
author_facet Tanaka, Shuhei
Imamura, Teruhiko
Ushijima, Ryuichi
Sobajima, Mitsuo
Fukuda, Nobuyuki
Ueno, Hiroshi
Hirai, Tadakazu
Kinugawa, Koichiro
author_sort Tanaka, Shuhei
collection PubMed
description Background and objectives: Endothelial dysfunction is associated with exercise intolerance and adverse cardiovascular events. Transcatheter aortic valve implantation (TAVI) is applied to treat elderly patients with severe aortic stenosis, but less is known about the impact of TAVI on endothelial dysfunction, which can be assessed by measuring flow-mediated vasodilation (FMD). In this parameter, a low value indicates impaired endothelial function. Materials and Methods: Vascular endothelial function was evaluated by FMD of the brachial artery just before and one week after TAVI. Factors associated with the normalization of FMD and their prognostic impact were investigated. Results: Fifty-one patients who underwent TAVI procedure (median 86 years old, 12 men) were included. FMD improved significantly from baseline to one week following TAVI (from 5.3% [3.7%, 6.7%] to 6.3% [4.7%, 8.1%], p < 0.001). Among 33 patients with baseline low FMD (≤6.0%), FMD normalized up to >6.0% following TAVI in 15 patients. Baseline higher cardiac index was independently associated with normalization of FMD following TAVI (odds ratio 11.8, 95% confidence interval 1.12–124; p < 0.04). Conclusions: Endothelial dysfunction improved following TAVI in many patients with severe aortic stenosis. The implication of this finding is the next concern.
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spelling pubmed-85399622021-10-24 Improvement in Vascular Endothelial Function following Transcatheter Aortic Valve Implantation Tanaka, Shuhei Imamura, Teruhiko Ushijima, Ryuichi Sobajima, Mitsuo Fukuda, Nobuyuki Ueno, Hiroshi Hirai, Tadakazu Kinugawa, Koichiro Medicina (Kaunas) Article Background and objectives: Endothelial dysfunction is associated with exercise intolerance and adverse cardiovascular events. Transcatheter aortic valve implantation (TAVI) is applied to treat elderly patients with severe aortic stenosis, but less is known about the impact of TAVI on endothelial dysfunction, which can be assessed by measuring flow-mediated vasodilation (FMD). In this parameter, a low value indicates impaired endothelial function. Materials and Methods: Vascular endothelial function was evaluated by FMD of the brachial artery just before and one week after TAVI. Factors associated with the normalization of FMD and their prognostic impact were investigated. Results: Fifty-one patients who underwent TAVI procedure (median 86 years old, 12 men) were included. FMD improved significantly from baseline to one week following TAVI (from 5.3% [3.7%, 6.7%] to 6.3% [4.7%, 8.1%], p < 0.001). Among 33 patients with baseline low FMD (≤6.0%), FMD normalized up to >6.0% following TAVI in 15 patients. Baseline higher cardiac index was independently associated with normalization of FMD following TAVI (odds ratio 11.8, 95% confidence interval 1.12–124; p < 0.04). Conclusions: Endothelial dysfunction improved following TAVI in many patients with severe aortic stenosis. The implication of this finding is the next concern. MDPI 2021-09-24 /pmc/articles/PMC8539962/ /pubmed/34684045 http://dx.doi.org/10.3390/medicina57101008 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tanaka, Shuhei
Imamura, Teruhiko
Ushijima, Ryuichi
Sobajima, Mitsuo
Fukuda, Nobuyuki
Ueno, Hiroshi
Hirai, Tadakazu
Kinugawa, Koichiro
Improvement in Vascular Endothelial Function following Transcatheter Aortic Valve Implantation
title Improvement in Vascular Endothelial Function following Transcatheter Aortic Valve Implantation
title_full Improvement in Vascular Endothelial Function following Transcatheter Aortic Valve Implantation
title_fullStr Improvement in Vascular Endothelial Function following Transcatheter Aortic Valve Implantation
title_full_unstemmed Improvement in Vascular Endothelial Function following Transcatheter Aortic Valve Implantation
title_short Improvement in Vascular Endothelial Function following Transcatheter Aortic Valve Implantation
title_sort improvement in vascular endothelial function following transcatheter aortic valve implantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539962/
https://www.ncbi.nlm.nih.gov/pubmed/34684045
http://dx.doi.org/10.3390/medicina57101008
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