title: Preserved autonomic regulation in patients undergoing transcatheter aortic valve implantation (TAVI): a prospective, comparative study.
abstract: Heart rate and blood pressure variability as well as baroreflex sensitivity (BRS) lead to additional insights on the patients' prognosis after cardiovascular events. The following study was performed to assess the differences in the postoperative recovery of the autonomic regulation after transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR). Fifty-eight consecutive patients were enrolled in a prospective study; 24 underwent TAVI and 34 SAVR. BRS was calculated according to the Dual Sequence Method, heart rate variability (HRV) was evaluated using standard linear as well as nonlinear parameters. HRV and BRS parameters were reduced after surgery in patients with SAVR only (meanNN: p<0.001, sdNN: p<0.05, Shannon: p<0.01, BRS: p<0.01), while these indexes were preserved in patients after TAVI. Simultaneously, an increased complexity of blood pressure (BP) in SAVR patients (fwShannon: p<0.001, fwRenyi4: p<0.001), but not in TAVI patients was recorded. In this study we were able to demonstrate for the first time that, in contrast to patients undergoing conventional open surgery, there are fewer alterations of the cardiovascular autonomic system in patients with TAVI.
authors.affiliation: German Heart Center Munich, Germany.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Retzlaff
authors.forename: Niels
authors.initials: N
authors.lastname: Wessel
authors.forename: Maik
authors.initials: M
authors.lastname: Riedl
authors.forename: Andrej
authors.initials: A
authors.lastname: Gapelyuk
authors.forename: Hagen
authors.initials: H
authors.lastname: Malberg
authors.forename: Nina
authors.initials: N
authors.lastname: Bauernschmitt
authors.forename: Jürgen
authors.initials: J
authors.lastname: Kurths
authors.forename: Georg
authors.initials: G
authors.lastname: Bretthauer
authors.forename: Robert
authors.initials: R
authors.lastname: Bauernschmitt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001341:Autonomic Nervous System / Q000503:physiopathology*; D017704:Baroreflex / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D006328:Cardiac Catheterization; D005260:Female; D006305:Health Status Indicators; D006339:Heart Rate / Q000502:physiology; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology*; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate