Relationship of arterial stiffness value with hemodynamic parameters in patients undergoing cardiac surgery

Hypotension during anesthesia induction is a clinically significant event linked to perioperative complications. This study aimed to assess if arterial stiffness and stiffness index, measured by Doppler ultrasonography (USG), can predict hypotension during anesthesia induction in cardiac surgery patients. Secondary objectives included exploring the relationship between arterial stiffness parameters and intraoperative hemodynamics, vasoactive drug use, length of hospital and intensive care unit (ICU) stays, and mortality.

This prospective, single-center observational study included patients undergoing elective open cardiac surgery between 1^st October 2022, and 1^st May 2023. Arterial stiffness was assessed preoperatively using carotid-femoral pulse wave velocity (PWV) and β-index via Doppler USG. The primary outcome was the development of hypotension during anesthesia induction.

A total of 121 patients were enrolled. The mean PWV was 8.1±3.2 m/s and the median β-index was 8 (range: 1-67). No significant association was found between PWV or β-index and the incidence of induction-related hypotension (p>0.05). PWV showed weak positive correlations with age (r=0.204; p=0.025) and minimum carotid diameter (r=0.219; p=0.016), while the β-index was positively correlated with baseline systolic pressure (ρ=0.260; p=0.004) and minimum carotid diameter (ρ=0.278; p=0.002). No significant correlation was observed with vasoactive drug use, ICU/hospital stay, or mortality (10%).

Preoperative arterial stiffness and stiffness index measured by Doppler USG did not predict anesthesia induction hypotension in cardiac surgery patients. Their clinical utility in this context appears limited, warranting further investigation.