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Vascular imaging, physiology and outcome

This interesting session provided useful and updated information in terms of vascular pathology from the thoracic aorta level to microvascular physiology and function. The speakers reminded the audience of well known pathophysiological principles of cardiovascular disease, while stressing in detail the interrelation of heart function and peripheral vessels.
Prof. Alan Gordon Fraser (Cardiff, UK) gave a talk regarding aortic stiffness and its additive risk in patients at cardiovascular risk. Increased aortic stiffness, as reflected by an increased pulse wave velocity or more specifically diagnosed by using magnetic resonance imaging (MRI) technology, is significantly and independently associated with higher risk of cardiovascular morbidity and mortality. Important information coming from basic research, (which, however, has to be thoroughly investigated before its wider clinical application), concerns the more beneficial contribution of atenonol to aortic stiffness in patients with Marfan syndrome as compared to renin angiotensin axis pharmacological agents.
Dr Javier Bermejo (Madrid, Spain), presented updated data regarding the important role of valvuloarterial impedance (Zva) in patients with aortic valve stenosis (AS). During his speech, he elucidated the contribution of valvuloarterial impedance as a measure of global afterload in AS, which takes systemic arterial compliance into account in addition to the severity of AS. The audience also had the opportunity to be informed about innovative haemodynamic data coming from pre- and post-transcatheter aortic valve interventions. A crucial moment of Dr Bermejo’s lecture was the reminder that each echocardiographic study, especially in AS cases, should provide information regarding the blood pressure of the patient during the index study, since this parameter affects the final assessment of the effective aortic orifice.
Dr Serge Kownator (Thionville, France) comprehensively developed on the microvascular contribution to the apprehension of circulatory physiology. The speaker recalled well known (flow-mediated dilation , FMD) and other, innovative methods of how to non-invasively assess the functionality of small vessels in several conditions.
Dr Muriel Sprynger (Liege, Belgium) spoke about vascular calcification and proved that this pathophysiological process is a clear ageing phenomenon. After categorizing vessel calcification to 3 distinct mechanisms, she concluded that this process is frequently observed but neglected in everyday clinical practice, and suggests unequivocally increased cardiovascular morbidity and mortality, whereas there are still no therapeutic strategies against it.




Vascular imaging, physiology and outcome

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.

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