High aortic pulse wave velocity is associated with poor quality of life in surgical aortic valve stenosis patients.
OBJECTIVE
Aortic stiffness is an emerging risk factor for cardiovascular disease. The predictive value of aortic pulse wave velocity (PWV) for quality of life (QoL) and severity of surgical aortic valve stenosis (AS) have not been examined.


METHODS
PWV was measured in patients undergoing aortic valve replacement (AVR) for AS. QoL [SF-36 and European QoL 5-dimensions (EQ-5D) questionnaires] was assessed pre- and postoperatively (409 ± 159 days). PWV was analysed: (i) as a continuous variable and (ii) as a dichotomous variable (PWV-norm and PWV-high groups) according to the published normal reference value.


RESULTS
Fifty-six patients (16 females), mean age of 71 ± 8.4 years, were included, and 50 (89%) patients completed follow-up. The two groups were matched for age, gender and classical haemodynamic measurements. There was no significant relation between AS severity and PWV. PWV-norm patients (n = 35) scored significantly better than PWV-high (n = 21) patients in the EQ-5D visual analogue scale and the EQ-5D index pre- (P < 0.001 and P = 0.03, respectively) and postoperatively (P < 0.001 for both). In SF-36, PWV-norm group scored better than PWV-high group in physical health domains preoperatively and in all domains postoperatively. Spearman's correlation was significant between PWV and QoL component summaries pre- and postoperatively. Among PWV, age and gender, multiple regression analysis demonstrated PWV to be independently related to QoL pre- and postoperatively (P-values ranged from <0.01 to <0.05).


CONCLUSIONS
PWV does not correlate with AS severity, but is associated with QoL before and after AVR. The published European PWV reference values can be used to categorise preoperative AS patients for QoL risk stratification.
Imperial College London, London, UK.
Emaddin
E
Kidher
Imperial College London, London, UK leanne.harling@imperial.ac.uk.
Leanne
L
Harling
Imperial College London, London, UK.
Petros
P
Nihoyannopoulos
Imperial College London, London, UK.
Natalie
N
Shenker
Imperial College London, London, UK.
Hutan
H
Ashrafian
Imperial College Healthcare NHS Trust, London, UK International Centre for Circulatory Health, Imperial College Healthcare NHS Trust, London, UK.
Darrel P
DP
Francis
Imperial College Healthcare NHS Trust, London, UK International Centre for Circulatory Health, Imperial College Healthcare NHS Trust, London, UK.
Jamil
J
Mayet
Imperial College London, London, UK.
Thanos
T
Athanasiou
D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000503:physiopathology*; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D003661:Decision Support Techniques; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D059289:Vascular Stiffness
Aortic stenosis; Aortic stiffness; Aortic valve; Arterial stiffness; Pulse wave velocity; Quality of life