Increased Pulse Wave Velocity and Arterial Hypertension in Young Patients With Thoracic Aortic Endografts
Increased Pulse Wave Velocity and Arterial Hypertension in Young Patients With Thoracic Aortic Endografts
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DOI：
10.1016/j.avsg.2011.06.021
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发表时间：
2012-05-01
影响因子：
1.5
通讯作者：
Boudoulas, Harisios
中科院分区：
文献类型：
--
作者：
Tzilalis, Vasileios D.;Kamvysis, Dimitrios;Boudoulas, Harisios
背景：胸主动脉腔内修复术（TEVAR）后的高血压是一种尚未得到广泛研究的医学并发症。本研究的目的是检验年轻胸主动脉横断患者中 TEVAR 改变脉搏波速度（PWV）和反射波速度并诱发动脉高血压的假设。 方法：回顾性收集和分析 11 例接受 TEVAR 治疗胸主动脉横断的年轻患者（均为男性，平均年龄 26.9 岁[范围：18-33]）的数据。对 PWV、收缩压 (SBP) 和脉压 (PP) 进行评估，并与 11 名年龄和性别相匹配的健康年轻人的记录进行比较。 结果：9 名患者在 TEVAR 后出现术后动脉高血压，4 名患者在随访期间（TEVAR 后 13-66 个月）出现持续性高血压。患者的 SBP、PP 和 PWV 均高于对照组（SBP：134.1 +/- 13.7 比 121.36 +/- 7.1 mm Hg，P = 0.016；PP：60.45 +/- 19.42 比 44.1 +/- 4.37，P = 0.020；PWV： 10.41 +/- 2.85 vs. 7.45 +/- 0.66 m/sec，P = 0.006）。结论：主动脉内移植物可能会导致脉动波中断，随后主动脉 PWV 增加。 PWV 升高是未来心血管事件的重要危险因素，应对 TEVAR 后的所有患者进行评估。
Background: Hypertension after thoracic endovascular aortic repair (TEVAR) is a medical complication not widely investigated. The aim of the study was to test the hypothesis that TEVAR in young patients suffering from thoracic aortic transection alters pulse wave velocity (PWV) and reflected wave velocity and induces arterial hypertension.Methods: The data concerning 11 young patients (all men with a mean age of 26.9 years [range: 18-33]) treated with TEVAR for thoracic aortic transection were retrospectively collected and analyzed. PWV, systolic blood pressure (SBP), and pulse pressure (PP) were evaluated and compared with those recorded in 11 healthy young individuals matched for age and gender.Results: Nine patients had postoperative arterial hypertension after TEVAR, and four had durable hypertension during the follow-up period (13-66 months after TEVAR). The SBP, the PP, and the PWV of the patients were greater compared with those of the control group (SBP: 134.1 +/- 13.7 vs. 121.36 +/- 7.1 mm Hg, P = 0.016; PP: 60.45 +/- 19.42 vs. 44.1 +/- 4.37, P = 0.020; and PWV: 10.41 +/- 2.85 vs. 7.45 +/- 0.66 m/sec, P = 0.006).Conclusions: Aortic endografts could produce a discontinuation of the pulsatile waves with a subsequent increase of aortic PWV. Increased PWV is an important risk factor for future cardiovascular events and should be evaluated in all patients after TEVAR.