BACKGROUND: In patients with aortic stenosis and a normal coronary angiogram, a coronary flow reserve (CFR) is impaired. The aim of the present study was to examine the effect of aortic valve replacement (AVR) on the CFR after a long-term follow-up. PATIENTS AND METHODS: 30 patients with aortic stenosis and a normal coronary angiogram were enrolled in the study. CFR measurements were made on 21 patients 123 +/- 137 days before and 497 +/- 167 days after AVR. CFR measurements were carried out according to a standard protocol, with a vasodilator stimulus dipyridamole (0.56 mg/kg for 4 min) and peak diastolic velocity measurements at 6 min. RESULTS: Initially, the average peak gradient of aortic stenosis was 89.5 +/- 22.4 mm Hg. After AVR, it decreased to 26.2 +/- 9 mm Hg. Left ventricular mass was significantly lower after AVR: 354.9 +/- 107.9 g versus 223.8 +/- 73.6 g (p < 0.001). The average baseline diastolic velocity measured by pulsed Doppler in the left anterior descending coronary artery amounted to 62.2 +/- 25.5 cm/s before and 40.1 +/- 13.6 cm/s after AVR. The difference was statistically significant (p < 0.01). The average diastolic velocity at maximum stress equaled 117 +/- 42.8 cm/s pre- and 91.5 +/- 34 cm/s postoperatively (p < 0.005). The calculated CFR before AVR amounted to 1.96 +/- 0.5 and increased to 2.37 +/- 0.8 postoperatively. The difference was statistically significant (p < 0.05). CONCLUSION: Prosthetic AVR is of considerable benefit concerning the CFR in patients with a normal coronary angiogram after a long-term follow-up.
BACKGROUND: In patients with aortic stenosis and a normal coronary angiogram, a coronary flow reserve (CFR) is impaired. The aim of the present study was to examine the effect of aortic valve replacement (AVR) on the CFR after a long-term follow-up. PATIENTS AND METHODS: 30 patients with aortic stenosis and a normal coronary angiogram were enrolled in the study. CFR measurements were made on 21 patients 123 +/- 137 days before and 497 +/- 167 days after AVR. CFR measurements were carried out according to a standard protocol, with a vasodilator stimulus dipyridamole (0.56 mg/kg for 4 min) and peak diastolic velocity measurements at 6 min. RESULTS: Initially, the average peak gradient of aortic stenosis was 89.5 +/- 22.4 mm Hg. After AVR, it decreased to 26.2 +/- 9 mm Hg. Left ventricular mass was significantly lower after AVR: 354.9 +/- 107.9 g versus 223.8 +/- 73.6 g (p < 0.001). The average baseline diastolic velocity measured by pulsed Doppler in the left anterior descending coronary artery amounted to 62.2 +/- 25.5 cm/s before and 40.1 +/- 13.6 cm/s after AVR. The difference was statistically significant (p < 0.01). The average diastolic velocity at maximum stress equaled 117 +/- 42.8 cm/s pre- and 91.5 +/- 34 cm/s postoperatively (p < 0.005). The calculated CFR before AVR amounted to 1.96 +/- 0.5 and increased to 2.37 +/- 0.8 postoperatively. The difference was statistically significant (p < 0.05). CONCLUSION: Prosthetic AVR is of considerable benefit concerning the CFR in patients with a normal coronary angiogram after a long-term follow-up.
Authors: Attila Nemes; Tamás Forster; Attila Thury; Zsolt Kovács; Krisztina Boda; Miklós Csanády Journal: Int J Cardiovasc Imaging Date: 2003-10 Impact factor: 2.357
Authors: Muhammad Sabbah; Niels Thue Olsen; Mikko Minkkinen; Lene Holmvang; Hans-Henrik Tilsted; Frants Pedersen; Francis R Joshi; Kiril Ahtarovski; Rikke Sørensen; Jesper James Linde; Lars Søndergaard; Nico Pijls; Jacob Lønborg; Thomas Engstrøm Journal: J Am Heart Assoc Date: 2022-04-26 Impact factor: 6.106
Authors: Jo M Zelis; Pim A L Tonino; Nico H J Pijls; Bernard De Bruyne; Richard L Kirkeeide; K Lance Gould; Nils P Johnson Journal: J Interv Cardiol Date: 2020-07-22 Impact factor: 2.279