Carotid Stiffness After Transcatheter Aortic Valve Replacement

Abstract

The present study aimed to analyze common carotid artery strain properties in patients (n = 59) with severe aortic valve stenosis who underwent transcatheter aortic valve replacement (TAVR). Arterial compliance of the common carotid artery was assessed by ultrasound speckle-tracking before and after TAVR. For sub-analysis the study cohort was divided according to aortic valve area <.75 cm2 (n = 30) vs ≥.75 cm2 (n = 29). Comparison of pre- and post-procedural strain variables showed an improvement in median radial velocity ( P < .0001), radial displacement ( P = .007), circumferential strain ( P = .004), radial strain rate ( P = .023), and circumferential strain rate ( P < .0001), while the increase of radial strain showed a trend ( P = .082). Analysis of aortic valve area revealed an inverse correlation between aortic valve area and the differences (post-procedural—pre-procedural values) for radial strain rate, and circumferential strain. Moreover, sub-analysis revealed that the increase of carotid strain variables before and after TAVR were more pronounced in the sub-group of aortic valve area .75 vs ≥.75 cm2. TAVR led to a reduction of arterial wall stiffness of the common carotid artery assessed by ultrasound speckle-tracking. The decrease of arterial wall stiffness after TAVR was more pronounced in more severe aortic valve stenosis.