Publications

Authors:

Pesarini, Gabriele; Scarsini, Roberto; Zivelonghi, Carlo; Piccoli, Anna; Gambaro, Alessia; Gottin, Leonardo; Rossi, Andrea; Ferrero, Valeria; Vassanelli, Corrado; Ribichini, Flavio Luciano

Title:

Functional Assessment of Coronary Artery Disease in Patients Undergoing Transcatheter Aortic Valve Implantation Influence of Pressure Overload on the Evaluation of Lesions Severity

Year:

2016

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Format:

Elettronico

Referee:

Sì

Name of journal:

CIRCULATION. CARDIOVASCULAR INTERVENTIONS.

ISSN of journal:

1941-7640

N° Volume:

9

Number or Folder:

11

Page numbers:

1-10

Keyword:

aortic stenosis, coronary artery disease, pressure overload

Short description of contents:

BACKGROUND: Aortic valve stenosis may influence fractional flow reserve (FFR) of concomitant coronary artery disease by causing hypertrophy and reducing the vasodilatory reserve of the coronary circulation. We sought to investigate whether FFR values might change after valve replacement. METHODS AND RESULTS: The functional relevance of 133 coronary lesions was assessed by FFR in 54 patients with severe aortic valve stenosis before and after transcatheter aortic valve implantation (TAVI) during the same procedure. A linear mixed model was used to verify the interaction of TAVI effect with the FFR values. No significant overall change in FFR values was found before and after the aortic valve stenosis removal (0.89±0.10 versus 0.89±0.13; P=0.73). A different trend in FFR groups (positive if ≤0.8; negative if >0.8) was found after TAVI (P for interaction <0.001). Positive FFR values worsened after TAVI (0.71±0.11 versus 0.66±0.14). Conversely, negative FFR values improved after TAVI (0.92±0.06 versus 0.93±0.07). Similarly, FFR values in coronary arteries with lesions presenting percent diameter stenosis >50 worsened after TAVI (0.84±0.12 versus 0.82±0.16; P=0.02), whereas FFR values in arteries with mild lesions (percent diameter stenosis <50) tended toward improvement after TAVI (0.90±0.07 versus 0.91±0.09; P=0.69). Functional FFR variations after TAVI changed the indication to treat the coronary stenosis in 8 of 133 (6%) lesions. CONCLUSIONS: Coronary hemodynamics are influenced by aortic valve stenosis removal. Nevertheless, FFR variations after TAVI are minor and crossed the diagnostic cutoff of 0.8 in a small number of patients after valve replacement. Borderline coronary lesions might become functionally significant after valve replacement, although FFR-guided interventions were infrequent even in patients with angiographically significant lesions.

Note:

the page range is based on the pdf file available on the publisher website

Product ID:

103366

Handle IRIS:

11562/980489

Last Modified:

November 12, 2022

Bibliographic citation:

Pesarini, Gabriele; Scarsini, Roberto; Zivelonghi, Carlo; Piccoli, Anna; Gambaro, Alessia; Gottin, Leonardo; Rossi, Andrea; Ferrero, Valeria; Vassanelli, Corrado; Ribichini, Flavio Luciano, Functional Assessment of Coronary Artery Disease in Patients Undergoing Transcatheter Aortic Valve Implantation Influence of Pressure Overload on the Evaluation of Lesions Severity «CIRCULATION. CARDIOVASCULAR INTERVENTIONS.» , vol. 9 , n. 11 , 2016 , pp. 1-10

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