Endovascular aortic repair impact on myocardial contractility: A prospective study

Background: This study aimed to estimate if the altered sphygmic wave transmission may affect the left ventricular (LV) contractile function in patients undergoing endovascular aortic repair (EVAR). Methods: A prospective single-centre study was carried out on consecutive patients undergoing EVAR for abdominal aortic aneurysm. A preoperative and 6-month single photon emission computed tomography (SPECT) with arterial stiffness measurement were performed to evaluate variations in pressure wave curve and myocardial perfusion parameters. Results: From 2018 to 2020 a total of 16 patients were included in the study. Among the parameters evaluated, we found a measurable reduction of the reflected wave transit time from pre-to postoperative period, for both stress (115.13 +/- 7.2 ms-111.1 +/- 7.0 ms, p =.08) and rest SPECT acquisitions (115.3 +/- 6.2 ms-112.2 +/- 5.6 ms, p =.1). Unidirectional increase of both LV end-systolic volume (34 +/- 9 mL-39 +/- 8 mL, p =.02) and end-diastolic volume (85 +/- 34 mL-89 +/- 29 mL, p =.6) was also observed. Lastly, the ratio between the end-systolic pressure and the end-systolic volume (maximal systolic myocardial stiffness) decreased from 3.6 +/- 1.5 mmHg/mL to 2.66 +/-.74 mmHg/mL (p =.03). Conclusions: Our data showed that EVAR induced an altered transmission of the sphygmic wave associated with an early LV contractile impairment.