Vascular Disease
Andrea Guala, PhD
Senior Researcher
Hospital Universitari Vall d'Hebron, CIBER-CV
barcelona, Catalonia, Spain
Andrea Guala, PhD
Senior Researcher
Hospital Universitari Vall d'Hebron, CIBER-CV
barcelona, Catalonia, Spain
Andrea Guala, PhD
Senior Researcher
Hospital Universitari Vall d'Hebron, CIBER-CV
barcelona, Catalonia, Spain
Daniel Gil-Sala, MD
Cardiac surgeon
Hospital Universitari Vall d'Hebron
Barcelona, Catalonia, Spain
Aroa Ruiz-Muñoz, MSc
Researcher
Hospital Universitari Vall d'Hebron, Spain
Marvin Ernesto E. García-Reyes, MD
Cardiac Surgeon
Hospital Universitari Vall d'Hebron, Spain
María Antonieta Azancot, MD
Doctor
Hospital Universitari Vall d'Hebron, Spain
Lydia Dux-Santoy, PhD
Researcher
Hospital Universitari Vall d'Hebron, Catalonia, Spain
Gisela Teixidó-Turà, MD, PhD
Cardiologist
Hospital Universitari Vall d'Hebron, Spain
Juan Garrido-Oliver, MSc
Researcher, engineer
Hospital Universitari Vall d'Hebron, Spain
Cristina Tello-Diaz, MD
Cardiac surgeon
Hospital Universitari Vall d'Hebron
Barcelona, Catalonia, Spain
Filipa Valente, MD
Cardiologist
Hospital Universitari Vall d'Hebron
Barcelona, Spain
Laura Galian-Gay, MD, PhD
Cardiologist
Hospital Universitari Vall d'Hebron
Barcelona, Catalonia, Spain
Alejandro Carrasco-Poves, MSc
Predoctoral researcher
Hospital Universitari Vall d'Hebron, Spain
Ignacio Ferreira-Gonzáiez, MD, PhD
Cardiologist
Hospital Universitari Vall d'Hebron, Spain
Artur Evangelista, MD, PhD
Cardiologist
Hospital Universitari Vall d'Hebron, Spain
Sergi Bellmunt, MD, PhD
Cardiac surgeon
Hospital Universitari Vall d'Hebron
Barcelona, Catalonia, Spain
Jose F Rodriguez Palomares, MD, PhD, FSCMR
Cardiologist
Hospital Universitari Vall d'Hebron
Barcelona, Spain
Endovascular aortic repair (TEVAR) is widely used in the treatment of injuries of the thoracic aortic in patients with blunt trauma. After repair, these normally healthy, young patients frequently develop hypertension (HT). The implantation of a TEVAR is associated with an increase in aortic stiffness (1,2), which might be responsible for the development of HT. Present research aimed at assessing the differences in ascending (AscAo) and abdominal (AbdAo) aorta stiffness associated with HT in these patients and at ascertaining whether certain properties of the implanted TEVAR are related to HT.
Methods:
Twenty-six patients who experienced a traumatic injury of the thoracic descending aorta and therefore underwent TEVAR implantation were included. All patients underwent 24-hour ambulatory blood pressure monitoring to diagnose HT, 4D flow CMR study to assess AscAo pulse wave velocity (PWV), cine CMR to quantify AscAo and AbdAo distensibility and AscAo longitudinal strain(3–5) and tonometry examination to measure carotid-femoral PWV (cfPWV). TEVAR characteristics were also identified
Results:
After 120.2 ± 69.7 months from intervention, the majority of patients (17, 65%) had HT. Comparing those who had (17) and had not (9) developed HT demonstrated no differences in terms of age, sex, BSA, aortic root maximum diameter, diameter of the ascending and descending aorta, nor in the prevalence of smocking and dyslipidaemia. For what concern TEVAR characteristics, distal (p=0.051) but not proximal (p=0.367) oversizing at implantation was larger in patients developing HT. On the other hand, proximal (p=1.000) and distal (p=0.597) diameter of the TEVAR and its length (p=0.525), as well as the time passed since TEVAR implantation (p=0.833), were similar in both groups. Patients developing HT had the TEVAR implanted more proximally (p=0.025), while the ending regions were similar in the two groups (p=0.597).
cfPWV tended to be higher in patients developing HT (p=0.066). Using reference values, cfPWV was abnormally high in 6 out of 17 patients with HT and in none of the 9 patients without HT (p=0.054). Finally, descriptors of regional AscAo stiffness were similar in the two groups: AscAo PWV (p=0.336), AscAo longitudinal strain (p=0.136) and AscAo (p=0.506) and AbdAo (0.466) distensibility.
Conclusion:
After long-term follow-up, the majority of patients with traumatic aortic injury treated with TEVAR presented hypertension. TEVAR but not native aorta stiffness, TEVAR proximal landing zone location and TEVAR distal oversizing were related to hypertension.