Valvular & structural heart disease
Long-term changes in coronary physiology after aortic valve replacement
Authors' conclusion
CFR in the LAD increased significantly at follow-up although global hyperaemic flow and minimal microvascular resistance remained unchanged.
Study context
- Population
- Patients with severe aortic stenosis (AS) undergoing aortic valve replacement (17 TAVI; 14 surgical bioprosthesis, 3 mechanical prosthesis) with invasive LAD assessment
- Participants
- 34 patients
- Exposure
- Before vs 6 months after aortic valve replacement
- Outcome
- CFR in the LAD (intracoronary bolus thermodilution)
- Follow-up
- 6 months after aortic valve replacement
Main finding
As reported in the abstract
CFR in the LAD · 6 months
Baseline
2.5
IQR 1.5–3.3
Follow-up
3.1
IQR 2.2–5.1
P = 0.005
Observational data: associations, not effects.
Further findings
Hyperaemic coronary flow (QLAD) · 6 months
P = 0.26
| Outcome | Baseline | Follow-up | Higher | P value |
|---|---|---|---|---|
| Minimal microvascular resistance (Rμ,LAD) · 6 months | 347 (IQR 247–463) | 287 (IQR 230–456) | P = 0.20 | |
| QLAD indexed for LVM · 6 monthsIQR 8-98% | 39% | P < 0.001 |
Correlation of coronary flow reserve (CFR) improvement with ΔLVSW
- R
- −0.39
- P
- P = 0.047
Original publication
Long-term changes in coronary physiology after aortic valve replacement. EuroIntervention. Published 20 February 2023. doi:10.
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