{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:23:00Z","timestamp":1790050980817,"version":"4.0.1"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T00:00:00Z","timestamp":1638921600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Valvular and arterial function are tightly intertwined, both in terms of structural changes and hemodynamics. While proximal valvulo-vascular coupling contributes to the cardiovascular consequences of aortic stenosis, less is known on how peripheral arterial stiffness relates to aortic valve disease. Previous studies have shown conflicting results regarding the impact of aortic valve replacement on arterial stiffness. The aim of the present study was therefore to determine predictors of arterial stiffness in patients with and without aortic valve disease undergoing cardiac surgery. Cardio ankle vascular index (CAVI) and carotid femoral pulse wave velocity (cfPWV) were measured to determine arterial stiffness the day before and 3 days after surgery for either ascending aortic or aortic valve disease. Stratification on indication for surgery revealed that CAVI was significantly lower in patients with aortic valve stenosis (<jats:italic>n<\/jats:italic> = 45) and aortic valve regurgitation (n=30) compared with those with isolated ascending aortic dilatation (<jats:italic>n<\/jats:italic> = 13). After surgery, a significant increased CAVI was observed in aortic stenosis (median 1.34, IQR 0.74\u20132.26, <jats:italic>p<\/jats:italic> &amp;lt; 0.001) and regurgitation (median 1.04, IQR 0.01\u20131.49, <jats:italic>p<\/jats:italic> = 0.003) patients while cfPWV was not significantly changed. Age, diabetes, low body mass index, low pre-operative CAVI, as well as changes in ejection time were independently associated with increased CAVI after surgery. The results of the present study suggest aortic valve disease as cause of underestimation of arterial stiffness when including peripheral segments. We report cardiovascular risk factors and pinpoint the hemodynamic aspect ejection time to be associated with increased CAVI after aortic valve surgery.<\/jats:p>","DOI":"10.3389\/fcvm.2021.754371","type":"journal-article","created":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T06:35:24Z","timestamp":1638945324000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["Cardiovascular Risk Factors and Hemodynamic Measures as Determinants of Increased Arterial Stiffness Following Surgical Aortic Valve Replacement"],"prefix":"10.3389","volume":"8","author":[{"given":"Oscar","family":"Plunde","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Franco-Cereceda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"B\u00e4ck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1318","DOI":"10.1016\/j.jacc.2009.10.061","article-title":"Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis","volume":"55","author":"Vlachopoulos","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1016\/j.echo.2014.12.011","article-title":"Arterial wave reflection and aortic valve calcification in an elderly community-based cohort","volume":"28","author":"Sera","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.ijcard.2020.03.081","article-title":"Determinants and clinical significance of aortic stiffness in patients with moderate or severe aortic stenosis","volume":"315","author":"Saeed","year":"2020","journal-title":"Int J Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"101","DOI":"10.5551\/jat.13.101","article-title":"A novel blood pressure-independent arterial wall stiffness parameter; cardio-ankle vascular index (CAVI)","volume":"13","author":"Shirai","year":"2006","journal-title":"J Atheroscler Thromb"},{"key":"B5","doi-asserted-by":"publisher","first-page":"318","DOI":"10.5603\/CJ.2013.0078","article-title":"Aortic valve sclerosis is a sign of increased arterial stiffness in clinically asymptomatic subjects","volume":"20","author":"Korkmaz","year":"2013","journal-title":"Cardiol J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e004590","DOI":"10.1161\/CIRCIMAGING.116.004590","article-title":"Valve, Ventricle, And Vessel: The Triumvirate Of Aortic Stenosis Assessment","volume":"9","author":"B\u00e4ck","year":"2016","journal-title":"Circ Cardiovasc Imaging"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1016\/j.jacc.2009.04.079","article-title":"Usefulness of the valvuloarterial impedance to predict adverse outcome in asymptomatic aortic stenosis","volume":"54","author":"Hachicha","year":"2009","journal-title":"J Am Coll Cardiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1845","DOI":"10.1097\/HJH.0000000000002141","article-title":"Pulse wave velocity can be accurately measured during transcatheter aortic valve implantation and used for post-procedure risk stratification","volume":"37","author":"Broyd","year":"2019","journal-title":"J Hypertens"},{"key":"B9","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1016\/j.jacc.2014.10.067","article-title":"Systemic vascular load in calcific degenerative aortic valve stenosis: insight from percutaneous valve replacement","volume":"65","author":"Yotti","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.ijcard.2005.07.023","article-title":"Changes in aortic root function after valve replacement in patients with aortic stenosis","volume":"110","author":"Barbetseas","year":"2006","journal-title":"Int J Cardiol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s12968-016-0256-z","article-title":"Assessment of aortic stiffness by cardiovascular magnetic resonance following the treatment of severe aortic stenosis by TAVI and surgical AVR","volume":"18","author":"Musa","year":"2016","journal-title":"J Cardiovasc Magn Reson"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e0207537","DOI":"10.1371\/journal.pone.0207537","article-title":"Transcatheter aortic valve replacement (TAVR) leads to an increase in the subendocardial viability ratio assessed by pulse wave analysis","volume":"13","author":"Muller","year":"2018","journal-title":"PLoS ONE"},{"key":"B13","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1007\/s00392-012-0473-x","article-title":"Effect of transcatheter aortic valve implantation on the ascending aorta's elasticity","volume":"101","author":"Vavuranakis","year":"2012","journal-title":"Clin Res Cardiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.ijcard.2020.08.040","article-title":"The impact of transcatheter aortic valve implantation on arterial stiffness and wave reflections","volume":"323","author":"Terentes-Printzios","year":"2020","journal-title":"Int J Cardiol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e010271","DOI":"10.1161\/JAHA.118.010271","article-title":"Arterial properties as determinants of left ventricular mass and fibrosis in severe aortic stenosis: findings from ACRIN PA 4008","volume":"8","author":"Chirinos","year":"2019","journal-title":"J Am Heart Assoc"},{"key":"B16","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/s40292-016-0176-x","article-title":"Arterial stiffness in aortic stenosis: relationship with severity and echocardiographic procedures response","volume":"24","author":"Bruschi","year":"2017","journal-title":"High Blood Press Cardiovasc Prev"},{"key":"B17","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1161\/HYP.0000000000000033","article-title":"Recommendations for improving and standardizing vascular research on arterial stiffness","volume":"66","author":"Townsend Raymond","year":"2015","journal-title":"Hypertension"},{"key":"B18","doi-asserted-by":"publisher","first-page":"2338","DOI":"10.1093\/eurheartj\/ehq165","volume":"31","year":"2010","journal-title":"Eur Heart J"},{"key":"B19","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1097\/HJH.0000000000001631","article-title":"Effects of metabolic syndrome on arterial function in different age groups: the Advanced Approach to Arterial Stiffness study","volume":"36","author":"Topouchian","year":"2018","journal-title":"J Hypertens"},{"key":"B20","doi-asserted-by":"publisher","first-page":"49","DOI":"10.5551\/jat.3582","article-title":"Contradictory effects of \u03b21- and \u03b11- aderenergic receptor blockers on cardio-ankle vascular stiffness index (CAVI)\u2013CAVI independent of blood pressure","volume":"18","author":"Shirai","year":"2011","journal-title":"J Atheroscler Thromb"},{"key":"B21","doi-asserted-by":"publisher","first-page":"B4","DOI":"10.1093\/eurheartj\/suw058","article-title":"Principles and usefulness of the cardio-ankle vascular index (CAVI): a new global arterial stiffness index","volume":"19","author":"Asmar","year":"2017","journal-title":"Eur Heart J Suppl"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1136\/heartjnl-2020-318733","article-title":"Relative survival after aortic valve surgery in patients with bicuspid aortic valves","volume":"107","author":"Glaser","year":"2021","journal-title":"Heart"},{"key":"B23","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur Heart J"},{"key":"B24","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/0021-9290(80)90191-8","article-title":"Stiffness and elastic behavior of human intracranial and extracranial arteries","volume":"13","author":"Hayashi","year":"1980","journal-title":"J Biomech"},{"key":"B25","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1016\/S0140-6736(00)95580-6","article-title":"Velocity of transmission of the pulse-wave: and elasticity of arteries","volume":"199","author":"Bramwell","year":"1922","journal-title":"Lancet"},{"key":"B26","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1186\/s12933-016-0465-7","article-title":"Association of metabolic syndrome and its components with arterial stiffness in Caucasian subjects of the MARK study: a cross-sectional trial","volume":"15","author":"Gomez-Sanchez","year":"2016","journal-title":"Cardiovasc Diabetol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1291\/hypres.25.359","article-title":"Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement","volume":"25","author":"Yamashina","year":"2002","journal-title":"Hypertens Res"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1020","DOI":"10.1016\/j.jcmg.2018.03.017","article-title":"Influence of aortic dilation on the regional aortic stiffness of bicuspid aortic valve assessed by 4-dimensional flow cardiac magnetic resonance: comparison with marfan syndrome and degenerative aortic aneurysm","volume":"12","author":"Guala","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"B29","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.ahj.2006.08.025","article-title":"Aortic valve replacement for aortic stenosis is associated with improved aortic distensibility at long-term follow-up","volume":"153","author":"Nemes","year":"2007","journal-title":"Am Heart J"},{"key":"B30","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/j.ijchv.2014.04.003","article-title":"Effects of transcatheter aortic valve implantation on ascending aorta wall elastic properties: tissue doppler imaging and strain doppler echocardiography study","volume":"4","author":"Vizzardi","year":"2014","journal-title":"Int J Cardiol Heart Vessel"},{"key":"B31","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1161\/01.RES.19.2.394","article-title":"Collagen and elastin content in canine arteries selected from functionally different vascular beds","volume":"19","author":"Fischer","year":"1966","journal-title":"Circ Res"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1050","DOI":"10.1161\/01.HYP.0000164580.39991.3d","article-title":"Structural and genetic bases of arterial stiffness","volume":"45","author":"Laurent","year":"2005","journal-title":"Hypertension"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1161\/01.ATV.18.7.1027","article-title":"Fibronectin expression and aortic wall elastic modulus in spontaneously hypertensive rats","volume":"18","author":"B\u00e9zie","year":"1998","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1161\/01.CIR.72.6.1257","article-title":"Regional wave travel and reflections along the human aorta: a study with six simultaneous micromanometric pressures","volume":"72","author":"Latham","year":"1985","journal-title":"Circulation"},{"key":"B35","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1007\/s10554-010-9772-3","article-title":"Acute improvement in arterial-ventricular coupling after transcatheter aortic valve implantation (CoreValve) in patients with symptomatic aortic stenosis","volume":"28","author":"Di Bello","year":"2012","journal-title":"Int J Cardiovasc Imaging"},{"key":"B36","doi-asserted-by":"publisher","first-page":"2048004017692277","DOI":"10.1177\/2048004017692277","article-title":"Arterial-ventricular coupling and parameters of vascular stiffness in hypertensive patients: role of gender","volume":"6","author":"Faconti","year":"2017","journal-title":"JRSM Cardiovasc Dis"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2147\/VHRM.S119646","article-title":"Inverse relationship of cardioankle vascular index with BMI in healthy Japanese subjects: a cross-sectional study","volume":"13","author":"Nagayama","year":"2016","journal-title":"Vasc Health Risk Manag"},{"key":"B38","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1093\/icvts\/ivu156","article-title":"High aortic pulse wave velocity is associated with poor quality of life in surgical aortic valve stenosis patients","volume":"19","author":"Kidher","year":"2014","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B39","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1093\/icvts\/ivu194","article-title":"Aortic stiffness is an indicator of cognitive dysfunction before and after aortic valve replacement for aortic stenosis","volume":"19","author":"Kidher","year":"2014","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B40","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1186\/1749-8090-9-102","article-title":"Aortic stiffness as a marker of cardiac function and myocardial strain in patients undergoing aortic valve replacement","volume":"9","author":"Kidher","year":"2014","journal-title":"J Cardiothorac Surg"},{"key":"B41","doi-asserted-by":"publisher","first-page":"41","DOI":"10.2147\/VHRM.S159437","article-title":"Pitfalls in the ankle-brachial index and brachial-ankle pulse wave velocity","volume":"14","author":"Ato","year":"2018","journal-title":"Vasc Health Risk Manag"},{"key":"B42","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1097\/01.hjh.0000523420.20485.b8","article-title":"Short-term repeatability of noninvasive aortic pulse wave velocity assessment: comparison between methods and devices","volume":"31","author":"Grillo","year":"2017","journal-title":"Am J Hypertens"},{"key":"B43","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1161\/HYPERTENSIONAHA.113.02046","article-title":"Opposite predictive value of pulse pressure and aortic pulse wave velocity on heart failure with reduced left ventricular ejection fraction: insights from an Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) substudy","volume":"63","author":"Regnault","year":"2014","journal-title":"Hypertension"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.754371\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T06:35:28Z","timestamp":1638945328000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.754371\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,8]]},"references-count":43,"alternative-id":["10.3389\/fcvm.2021.754371"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2021.754371","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,8]]},"article-number":"754371"}}