Valvular & structural heart diseaseCohort study
Coronary Physiological Indexes to Evaluate Myocardial Ischemia in Patients With Aortic Stenosis Undergoing Valve Replacement
- Prospective cohort study
- multicentre
Authors' conclusion
In patients with severe AS and CAD, FFR ≤0.83 and RFR ≤0.85 appear to predict myocardial ischemia more accurately. Six months after AVR, FFR decreases, whereas RFR increases significantly with a simultaneous decrease of left ventricular mass and an improvement of microvascular function.
Study context
- Population
- Patients with severe AS and intermediate to severe coronary artery disease (CAD) undergoing aortic valve replacement (AVR)
- Participants
- 116 patients · 146 coronary lesions
- Exposure
- Coronary physiological indexes before vs after AVR
Main finding
As reported in the abstract
Change in FFR and RFR after AVR · 6 months after AVR
- Fractional flow reserve (FFR) change (mean ± SD)
- −0.0279 ± 0.0368
- RFR change (mean ± SD)
- +0.0410 ± 0.0487
- P for both
- P < 0.0001
- Lesions crossing traditional FFR cutoff
- 21.5% (21/98)
- Lesions crossing traditional RFR cutoff
- 39.8% (39/98)
Observational data: associations, not effects.
Further findings
LV mass · before vs after AVR
- LV mass decreased significantly: 153.68 ± 44.22 g before vs 134.66 ± 37.26 g after
- P < 0.0001
Microvascular dysfunction at baseline
- Abnormal index of microvascular resistance
- 32.1%
- Abnormal microvascular resistance reserve
- 68.6%
- All microvascular parameters improved after AVR
Original publication
Coronary Physiological Indexes to Evaluate Myocardial Ischemia in Patients With Aortic Stenosis Undergoing Valve Replacement. JACC Cardiovasc Interv. Published 28 October 2024. doi:10.1016/j.jcin.2024.10.024
Summarised from the published abstract; every number is checked against it