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• W4387526297 abstract "<h3>Background/Introduction</h3> Untreated symptomatic severe aortic stenosis (AS) has a 50% two-year mortality rate and valve replacement is the only meaningful treatment. Autonomic nervous system (ANS) dysfunction determined by speed of heart rate recovery post active stand test (HRR10–20) is associated with increased all-cause mortality, and aortic stenosis is known to modulate autonomic function. We have previously shown that patients with severe aortic stenosis have impaired HRR10–20 versus age and sex matched controls without. <h3>Purpose</h3> To assess HRR10–20 in patients with severe aortic stenosis before and after valve replacement. We have shown HRR10–20 is significantly impaired in patients with symptomatic severe AS compared to controls without AS, 2.06 bpm( 95% CI -2.58 to + 6.70) v -2.6bpm (95% CI -4.2 to -1.07), p=0.016. We hypothesise autonomic function will improve post aortic valve replacement, and persisting abnormalities could represent a higher risk of morbidity and mortality. <h3>Methods</h3> After ethical approval and informed consent, patients with severe aortic stenosis attending a tertiary referral centre were enrolled. All patients had an active stand before and after aortic valve replacement. During an active stand, real-time heart rate, blood pressure and ECG recordings were taken using non-invasive digital photoplethysmography and HRR10–20 was determined. Assessment of autonomic function was performed by determining speed of HRR10–20 post-orthostatic challenge. <h3>Results</h3> We have enrolled 21 patients to date, all were Caucasian, 52.4% male (n=11), mean age was 77.9 years and mean BMI was 27.1 (range 16.8 – 42.4). The predominant comorbidities were hypertension (80.9%), ischaemic heart disease (47.6%) and diabetes (23.8%). Heart rate recovery following active stand (HRR10–20) did not change significantly following aortic valve replacement in patients with symptomatic severe AS when repeated at a mean of 4 months post procedure, -0.13bpm (95% CI -3.6 to 3.35) v 2.1bpm (95% CI -2.1 to 6.3), p=0.19. Furthermore maximum HR (12.9bpm (95% CI 9.5 – 16.2) v 11.9bpm (95% CI 8.7 – 15.2), p = 0.24) and minimum HR (7.0bpm (95% CI 4.6 – 9.5) v 6.8bpm (95% CI 4.5 – 9.0), p = 0.41) changes from baseline following active standing were not altered following valve replacement (figure 1). <h3>Conclusion</h3> Patients with aortic stenosis have significantly impaired heart rate recovery time when compared to age and sex matched controls. HRR10–20 does not improve significantly in the short term after aortic valve replacement." @default.
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• W4387526297 date "2023-10-01" @default.
• W4387526297 modified "2023-10-12" @default.
• W4387526297 title "30 Cardiovascular autonomic function assessed by heart rate recovery following active stand test in patients with severe aortic stenosis and response to aortic valve replacement" @default.
• W4387526297 doi "https://doi.org/10.1136/heartjnl-2023-ics.30" @default.
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