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Coronary flow reserve improves after aortic valve replacement for aortic stenosis: an adenosine transthoracic

D J Hildick-Smith1, L M Shapiro

  • 1Cardiac Unit, Papworth Hospital, Cambridge, United Kingdom. david.hildick-smith@papworth-tr.anglox.nhs.uk

Journal of the American College of Cardiology
|November 25, 2000
PubMed

Insights

Coronary flow reserve (CFR) significantly improves after aortic valve replacement (AVR) for aortic stenosis. This enhancement in CFR is associated with the regression of left ventricular hypertrophy.

Area of Science:

  • Cardiovascular Medicine
  • Cardiac Surgery
  • Diagnostic Imaging

Background:

  • Coronary flow reserve (CFR) can be impaired by left ventricular (LV) hypertrophy.
  • The impact of LV hypertrophy regression on CFR in humans following aortic valve replacement (AVR) is not well-established.

Purpose of the Study:

  • To evaluate changes in coronary flow reserve (CFR) before and after aortic valve replacement (AVR).
  • To investigate the relationship between left ventricular (LV) hypertrophy regression and CFR improvement post-AVR.

Main Methods:

  • Adenosine transthoracic echocardiography was used to assess 35 patients with aortic stenosis and LV hypertrophy before and six months after AVR.
  • Measurements included left ventricular mass, distal left anterior descending coronary artery (LAD) diameter, flow, and CFR.

Main Results:

  • A significant reduction in left ventricular mass was observed post-AVR.
  • While resting coronary artery flow parameters remained unchanged, hyperemic flow and coronary flow reserve (CFR) significantly increased after AVR.
  • CFR increased from 1.76 to 2.61 post-AVR.

Conclusions:

  • Aortic valve replacement for aortic stenosis leads to a significant increase in coronary flow reserve.
  • The improvement in CFR is directly linked to the regression of left ventricular hypertrophy.
Abstract

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