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Determining the Pre...
Determining the Predominant Lesion in Patients With Severe Aortic Stenosis and Coronary Stenoses : A Multicenter Study Using Intracoronary Pressure and Flow
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- Ahmad, Yousif (författare)
- Hammersmith Hospital,Imperial College London
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- Vendrik, Jeroen (författare)
- Academic Medical Center of University of Amsterdam (AMC),University of Amsterdam
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- Eftekhari, Ashkan (författare)
- Aarhus University Hospital Skejby
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- Howard, James P. (författare)
- Hammersmith Hospital,Imperial College London
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- Cook, Christopher (författare)
- Imperial College London,Hammersmith Hospital
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- Rajkumar, Christopher (författare)
- Hammersmith Hospital,Imperial College London
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- Malik, Iqbal (författare)
- Hammersmith Hospital,Imperial College Healthcare NHS Trust
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- Mikhail, Ghada (författare)
- Imperial College Healthcare NHS Trust,Hammersmith Hospital
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- Ruparelia, Neil (författare)
- Imperial College Healthcare NHS Trust,Hammersmith Hospital
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- Hadjiloizou, Nearchos (författare)
- Hammersmith Hospital,Imperial College Healthcare NHS Trust
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- Nijjer, Sukhjinder (författare)
- Hammersmith Hospital,Imperial College Healthcare NHS Trust
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- Al-Lamee, Rasha (författare)
- Imperial College London,Hammersmith Hospital
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- Petraco, Ricardo (författare)
- Imperial College London,Hammersmith Hospital
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- Warisawa, Takayuki (författare)
- Hammersmith Hospital,Imperial College London
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- Wijntjens, Gilbert W.M. (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam
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- Koch, Karel T. (författare)
- Academic Medical Center of University of Amsterdam (AMC),University of Amsterdam
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- van de Hoef, Tim (författare)
- University of Amsterdam,Academic Medical Center of University of Amsterdam (AMC)
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- de Waard, Guus (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam
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- Echavarria-Pinto, Mauro (författare)
- Hospital Clinico San Carlos de Madrid
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- Frame, Angela (författare)
- Hammersmith Hospital,Imperial College Healthcare NHS Trust
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- Sutaria, Nilesh (författare)
- Hammersmith Hospital,Imperial College Healthcare NHS Trust
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- Kanaganayagam, Gajen (författare)
- Hammersmith Hospital,Imperial College Healthcare NHS Trust
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- Ariff, Ben (författare)
- Imperial College Healthcare NHS Trust,Hammersmith Hospital
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- Anderson, Jon (författare)
- Imperial College Healthcare NHS Trust,Hammersmith Hospital
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- Chukwuemeka, Andrew (författare)
- Imperial College Healthcare NHS Trust,Hammersmith Hospital
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- Fertleman, Michael (författare)
- Imperial College Healthcare NHS Trust,Hammersmith Hospital
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- Koul, Sasha (författare)
- Lund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital
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- Iglesias, Juan F. (författare)
- Lausanne University Hospital
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- Francis, Darrel (författare)
- Imperial College London,Hammersmith Hospital
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- Mayet, Jamil (författare)
- Imperial College London,Hammersmith Hospital
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- Serruys, Patrick (författare)
- Imperial College London,Hammersmith Hospital
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- Davies, Justin (författare)
- Imperial College Healthcare NHS Trust,Hammersmith Hospital
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- Escaned, Javier (författare)
- Hospital Clinico San Carlos de Madrid
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- van Royen, Niels (författare)
- Amsterdam UMC - Vrije Universiteit Amsterdam
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- Götberg, Matthias (författare)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Juhl Terkelsen, Christian (författare)
- Aarhus University Hospital Skejby
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- Høj Christiansen, Evald (författare)
- Aarhus University Hospital Skejby
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- Piek, Jan J. (författare)
- Academic Medical Center of University of Amsterdam (AMC),University of Amsterdam
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- Baan, Jan (författare)
- Academic Medical Center of University of Amsterdam (AMC),University of Amsterdam
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- Sen, Sayan (författare)
- Hammersmith Hospital,Imperial College London
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(creator_code:org_t)
- 2019
- 2019
- Engelska.
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Ingår i: Circulation. Cardiovascular Interventions. - 1941-7632. ; 12:12
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BACKGROUND: Patients with severe aortic stenosis (AS) often have coronary artery disease. Both the aortic valve and the coronary disease influence the blood flow to the myocardium and its ability to respond to stress; leading to exertional symptoms. In this study, we aim to quantify the effect of severe AS on the coronary microcirculation and determine if this is influenced by any concomitant coronary disease. We then compare this to the effect of coronary stenoses on the coronary microcirculation. METHODS: Group 1: 55 patients with severe AS and intermediate coronary stenoses treated with transcatheter aortic valve implantation (TAVI) were included. Group 2: 85 patients with intermediate coronary stenoses and no AS treated with percutaneous coronary intervention were included. Coronary pressure and flow were measured at rest and during hyperemia in both groups, before and after TAVI (group 1) and before and after percutaneous coronary intervention (group 2). RESULTS: Microvascular resistance over the wave-free period of diastole increased significantly post-TAVI (pre-TAVI, 2.71±1.4 mm Hg·cm·s-1 versus post-TAVI 3.04±1.6 mm Hg·cm·s-1 [P=0.03]). Microvascular reserve over the wave-free period of diastole significantly improved post-TAVI (pre-TAVI 1.88±1.0 versus post-TAVI 2.09±0.8 [P=0.003]); this was independent of the severity of the underlying coronary stenosis. The change in microvascular resistance post-TAVI was equivalent to that produced by stenting a coronary lesion with an instantaneous wave-free ratio of ≤0.74. CONCLUSIONS: TAVI improves microcirculatory function regardless of the severity of underlying coronary disease. TAVI for severe AS produces a coronary hemodynamic improvement equivalent to the hemodynamic benefit of stenting coronary stenoses with instantaneous wave-free ratio values <0.74. Future trials of physiology-guided revascularization in severe AS may consider using this value to guide treatment of concomitant coronary artery disease.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- aortic valve stenosis
- diastole
- hyperemia
- microcirculation
- myocardium
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Ahmad, Yousif
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Vendrik, Jeroen
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Eftekhari, Ashka ...
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Howard, James P.
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Cook, Christophe ...
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Rajkumar, Christ ...
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visa fler...
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Malik, Iqbal
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Mikhail, Ghada
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Ruparelia, Neil
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Hadjiloizou, Nea ...
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Nijjer, Sukhjind ...
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Al-Lamee, Rasha
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Petraco, Ricardo
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Warisawa, Takayu ...
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Wijntjens, Gilbe ...
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Koch, Karel T.
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van de Hoef, Tim
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de Waard, Guus
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Echavarria-Pinto ...
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Frame, Angela
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Sutaria, Nilesh
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Kanaganayagam, G ...
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Ariff, Ben
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Anderson, Jon
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Chukwuemeka, And ...
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Fertleman, Micha ...
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Koul, Sasha
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Iglesias, Juan F ...
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Francis, Darrel
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Mayet, Jamil
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Serruys, Patrick
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Davies, Justin
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Escaned, Javier
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van Royen, Niels
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Götberg, Matthia ...
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Juhl Terkelsen, ...
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Høj Christiansen ...
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Piek, Jan J.
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Baan, Jan
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Sen, Sayan
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
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Circulation. Car ...
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Lunds universitet