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[Aortic stenosis and coronary pathology. Their implications for the transvalvular gradient]
Cardiologia (Rome, Italy)
|June 1, 1992
Summary
Coronary artery disease is common in patients with aortic stenosis, impacting ejection fraction and limiting the use of peak systolic valvular gradient. Coronary angiography is recommended regardless of chest pain presence.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Valvular aortic stenosis (AS) is a common valvular heart disease.
- Coronary artery disease (CAD) prevalence in AS patients requires further investigation.
- The relationship between AS severity indices and CAD is not fully understood.
Purpose of the Study:
- To determine the incidence of CAD in patients with valvular AS.
- To assess the impact of CAD on peak systolic valvular gradient (PSVG) and ejection fraction (EF).
- To evaluate the necessity of coronary angiography in AS patients.
Main Methods:
- Cardiac catheterization was performed on 31 consecutive patients with valvular AS.
- Coronary angiography assessed significant CAD (>50% luminal diameter reduction).
- Statistical analysis correlated CAD presence with risk factors, age, angina, PSVG, and EF.
Main Results:
- Significant CAD was found in 54.8% of AS patients.
- CAD prevalence was not correlated with age or typical angina.
- Patients with CAD had significantly lower ejection fraction (45% vs. 65.1%) and a reverse correlation with PSVG (p=0.006).
Conclusions:
- Peak systolic valvular gradient is a limited index for AS severity in patients with concomitant CAD.
- The presence of CAD significantly affects ejection fraction in AS patients.
- Coronary angiography is essential for all AS patients, irrespective of angina symptoms, to align with ACC/AHA guidelines.