Related Experiment Video
Updated: Jan 24, 2026
A Rabbit Aortic Valve Stenosis Model Induced by Direct Balloon Injury
Published on: March 31, 2023
Low systemic arterial compliance is associated with increased cardiovascular morbidity and mortality in aortic valve
Edda Bahlmann1, Dana Cramariuc2, Sahrai Saeed2
1Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany.
Insights
Low systemic arterial compliance (SAC) in aortic valve stenosis (AS) patients independently predicts higher cardiovascular and all-cause mortality. This finding highlights SAC as a crucial prognostic indicator in AS management.
Area of Science:
- Cardiovascular Medicine
- Clinical Research
- Hemodynamics
Background:
- Systemic arterial compliance (SAC) is linked to cardiovascular outcomes in hypertension.
- The prognostic value of SAC in aortic valve stenosis (AS) has not been prospectively evaluated.
- Asymptomatic mild-moderate AS patients often have comorbidities like hypertension.
Purpose of the Study:
- To prospectively assess the association between low systemic arterial compliance (SAC) and cardiovascular outcomes in patients with aortic valve stenosis (AS).
- To determine if low SAC is an independent predictor of mortality in AS patients.
Main Methods:
- Utilized data from 1641 initially asymptomatic mild-moderate AS patients from the Simvastatin and Ezetimibe in Aortic Stenosis study.
- Assessed SAC using the Doppler stroke volume index to central pulse pressure ratio, defining low SAC as ≤0.64 mL/m².
- Employed Cox regression analysis to evaluate the association of SAC with cardiovascular death and all-cause mortality, adjusting for relevant covariates.
Main Results:
- Low SAC was associated with older age, female sex, hypertension, obesity, and more severe AS.
- Low SAC independently predicted higher cardiovascular death (HR 2.13) and all-cause mortality (HR 1.71) (p=0.001).
- These associations remained significant after adjusting for blood pressure, AS severity, and discordantly graded AS.
Conclusions:
- In patients with AS, particularly those with hypertension but without diabetes or prior cardiovascular disease, low SAC is a significant independent predictor of increased cardiovascular and all-cause mortality.
- Low SAC identifies a high-risk subgroup within the AS population.
- Findings underscore the importance of assessing arterial compliance in AS management.
Objective:
Lower systemic arterial compliance (SAC) is associated with increased cardiovascular morbidity and mortality in hypertension, but this has not been assessed in a prospective study in aortic valve stenosis (AS).
Methods:
Data from 1641 patients (38% women) with initially asymptomatic mild-moderate AS enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study was used. Median follow-up was 4.3 years. SAC was assessed from Doppler stroke volume index to central pulse pressure ratio and considered low if ≤0.64 mL/m², corresponding to the lower tertile in the population. The association of SAC with outcome was assessed in Cox regression analysis and reported as HR and 95% CI.
Results:
Low SAC at baseline was characterised by older age, female sex, hypertension, obesity, presence of a small aortic root, lower mean aortic gradient and more severe AS by effective aortic valve area (all p<0.01). In Cox regression analysis adjusting for factors, low SAC was associated with higher HRs for cardiovascular death (HR 2.13(95% CI 1.34 to 3.40) and all-cause mortality (HR 1.71(95% CI 1.23 to 2.38)), both p=0.001). The results did not change when systolic or diastolic blood pressure, other measures of AS severity or presence of discordantly graded AS were included in subsequent models. Presence of low SAC did not improve mortality prediction in reclassification analysis.
Conclusions:
In patients with AS without diabetes and known cardiovascular disease, but a high prevalence of hypertension, low SAC was associated with higher cardiovascular and all-cause mortality independent of well-known prognosticators.
Trial Registration Number:
NCT00092677; Post-results.
More Related Videos
06:51Author Spotlight: Development of a Minimally Invasive Large-Animal Model for Reliable and Reproducible Cardiovascular Research
Published on: October 20, 2023
12:17Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Related Concept Videos
01:11Overview of Systemic Arteries
Systemic circulation is the part of the cardiovascular system that carries oxygenated blood away from the heart to the body's tissues and returns deoxygenated blood back to the...
01:14Overview of the Cardiovascular System
Heart
The heart is the central pump of the cardiovascular system that circulates blood throughout the body. It comprises two atria receiving the blood and two ventricles pumping blood out of the heart. Their rhythmic contractions, called heartbeats, ensure that blood flow remains continuous.
Blood Vessels
Blood...
01:16Heart Valves
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
01:22Mitral Stenosis I: Introduction
01:25Increased Body Temperature
01:17Increased pulse rate
Many factors can elevate the risk of developing tachycardia. These include advanced age, a family history of arrhythmias, and an...