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  • Ahmad, YousifHammersmith Hospital,Imperial College London (författare)

Determining the Predominant Lesion in Patients With Severe Aortic Stenosis and Coronary Stenoses : A Multicenter Study Using Intracoronary Pressure and Flow

  • Artikel/kapitelEngelska2019

Förlag, utgivningsår, omfång ...

  • 2019

Nummerbeteckningar

  • LIBRIS-ID:oai:lup.lub.lu.se:7d239867-1368-4d7a-bd5c-97fd986acca7
  • https://lup.lub.lu.se/record/7d239867-1368-4d7a-bd5c-97fd986acca7URI
  • https://doi.org/10.1161/CIRCINTERVENTIONS.119.008263DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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Klassifikation

  • Ämneskategori:art swepub-publicationtype
  • Ämneskategori:ref swepub-contenttype

Anmärkningar

  • 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 och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Vendrik, JeroenAcademic Medical Center of University of Amsterdam (AMC),University of Amsterdam (författare)
  • Eftekhari, AshkanAarhus University Hospital Skejby (författare)
  • Howard, James P.Hammersmith Hospital,Imperial College London (författare)
  • Cook, ChristopherImperial College London,Hammersmith Hospital (författare)
  • Rajkumar, ChristopherHammersmith Hospital,Imperial College London (författare)
  • Malik, IqbalHammersmith Hospital,Imperial College Healthcare NHS Trust (författare)
  • Mikhail, GhadaImperial College Healthcare NHS Trust,Hammersmith Hospital (författare)
  • Ruparelia, NeilImperial College Healthcare NHS Trust,Hammersmith Hospital (författare)
  • Hadjiloizou, NearchosHammersmith Hospital,Imperial College Healthcare NHS Trust (författare)
  • Nijjer, SukhjinderHammersmith Hospital,Imperial College Healthcare NHS Trust (författare)
  • Al-Lamee, RashaImperial College London,Hammersmith Hospital (författare)
  • Petraco, RicardoImperial College London,Hammersmith Hospital (författare)
  • Warisawa, TakayukiHammersmith Hospital,Imperial College London (författare)
  • Wijntjens, Gilbert W.M.Amsterdam UMC - Vrije Universiteit Amsterdam (författare)
  • Koch, Karel T.Academic Medical Center of University of Amsterdam (AMC),University of Amsterdam (författare)
  • van de Hoef, TimUniversity of Amsterdam,Academic Medical Center of University of Amsterdam (AMC) (författare)
  • de Waard, GuusAmsterdam UMC - Vrije Universiteit Amsterdam (författare)
  • Echavarria-Pinto, MauroHospital Clinico San Carlos de Madrid (författare)
  • Frame, AngelaHammersmith Hospital,Imperial College Healthcare NHS Trust (författare)
  • Sutaria, NileshHammersmith Hospital,Imperial College Healthcare NHS Trust (författare)
  • Kanaganayagam, GajenHammersmith Hospital,Imperial College Healthcare NHS Trust (författare)
  • Ariff, BenImperial College Healthcare NHS Trust,Hammersmith Hospital (författare)
  • Anderson, JonImperial College Healthcare NHS Trust,Hammersmith Hospital (författare)
  • Chukwuemeka, AndrewImperial College Healthcare NHS Trust,Hammersmith Hospital (författare)
  • Fertleman, MichaelImperial College Healthcare NHS Trust,Hammersmith Hospital (författare)
  • Koul, SashaLund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-sku (författare)
  • Iglesias, Juan F.Lausanne University Hospital (författare)
  • Francis, DarrelImperial College London,Hammersmith Hospital (författare)
  • Mayet, JamilImperial College London,Hammersmith Hospital (författare)
  • Serruys, PatrickImperial College London,Hammersmith Hospital (författare)
  • Davies, JustinImperial College Healthcare NHS Trust,Hammersmith Hospital (författare)
  • Escaned, JavierHospital Clinico San Carlos de Madrid (författare)
  • van Royen, NielsAmsterdam UMC - Vrije Universiteit Amsterdam (författare)
  • Götberg, MatthiasLund 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(Swepub:lu)kard-mgo (författare)
  • Juhl Terkelsen, ChristianAarhus University Hospital Skejby (författare)
  • Høj Christiansen, EvaldAarhus University Hospital Skejby (författare)
  • Piek, Jan J.Academic Medical Center of University of Amsterdam (AMC),University of Amsterdam (författare)
  • Baan, JanAcademic Medical Center of University of Amsterdam (AMC),University of Amsterdam (författare)
  • Sen, SayanHammersmith Hospital,Imperial College London (författare)
  • Hammersmith HospitalImperial College London (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Circulation. Cardiovascular Interventions12:121941-7632

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