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-center 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 into 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 msec to 111.1 ± 7.0 msec, p = 0.08) and rest SPECT acquisitions (115.3 ± 6.2 msec to 112.2 ± 5.6 msec, p = 0.1). Unidirectional increase of both LV end-systolic volume (34 ± 9 ml to 39 ± 8 ml, p = 0.02) and end-diastolic volume (85 ± 34 ml to 89 ± 29 ml, p = 0.6) 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 ± 0.74 mmHg/ml (p = 0.03). Conclusions: Our data showed that EVAR induced an altered transmission of the sphygmic wave associated with an early LV contractile impairment.