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Titolo:
Coronary flow reserve improves after aortic valve replacement for aortic stenosis: An adenosine transthoracic echocardiography study
Autore:
Hildick-Smith, DJR; Shapiro, LM;
Indirizzi:
Papworth Hosp, Cardiac Unit, Cambridge CB3 8RE, England Papworth Hosp Cambridge England CB3 8RE Unit, Cambridge CB3 8RE, England
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 6, volume: 36, anno: 2000,
pagine: 1889 - 1896
SICI:
0735-1097(20001115)36:6<1889:CFRIAA>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR HYPERTROPHY; MYOCARDIAL BLOOD-FLOW; VASCULAR RESERVE; ANGINA-PECTORIS; DOPPLER-ECHOCARDIOGRAPHY; NONINVASIVE ASSESSMENT; ARTERIAL-HYPERTENSION; CARDIAC-HYPERTROPHY; VASODILATOR RESERVE; PRESSURE-OVERLOAD;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
68
Recensione:
Indirizzi per estratti:
Indirizzo: Hildick-Smith, DJR Papworth Hosp, Cardiac Unit, Cambridge CB3 8RE, EnglandPapworth Hosp Cambridge England CB3 8RE 8RE, England
Citazione:
D.J.R. Hildick-Smith e L.M. Shapiro, "Coronary flow reserve improves after aortic valve replacement for aortic stenosis: An adenosine transthoracic echocardiography study", J AM COL C, 36(6), 2000, pp. 1889-1896

Abstract

OBJECTIVES The goal of this study was to assess coronary flow reserve (CFR) before and after aortic valve replacement (AVR). BACKGROUND Coronary flow reserve is impaired under conditions of left ventricular (LV) hypertrophy. It is not known whether CFR improves with regression of LV hypertrophy in humans. METHODS We investigated 35 patients with pure aortic stenosis, LV hypertrophy and normal coronary arteriograms. Patients underwent adenosine transthoracic echocardiography on two occasions-immediately before AVR and six months postoperatively. Left ventricular mass, distal left anterior descending coronary artery (LAD) diameter, flow and CFR were assessed on each occasion. RESULTS Distal LAD diameter was successfully imaged in 30 patients (86%), and blood flow was successfully imaged in 27 (77%). Paired data were subsequently available in 24 patients, of whom 14 were men, mean age 68.1 +/-: 12.5 years, body mass index 24.5 +/- 2.0 kg/m(2), aortic valve gradient 93 +/- 32 mm Hg. Pre- to post-AVR a significant decrease nas seen in LV mass (271 +/- 38 vs. 236 +/- 32g, p < 0.01) and LV mass index (154 +/- 21 vs. 134 +/- 21g/m(2), p < 0.01). Distal LAD diameter fell from 2.27 +/- 0.37 to 2.23+/- 0.35 mm, p = 0.08). Pre- to post-AVR there was no significant change in resting parameters of peak diastolic velocity (0.43 +/- 0.16 vs. 0.41 +/-0.11 m/s), distal LAD flow 23.3 +/- 10.1 vs. 20.9 +/- 5.2 ml/min or distalLAD flow scaled for LV mass (8.7 +/- 3.8 vs. 9.0 +/- 2.5 ml/min/100 g LV mass), but there was significant increase in hyperemic peak diastolic velocity(0.71 +/- 0.26 vs. 1.08 +/-. 0.24 m/s; p < 0.01), distal LAD how (37.8 +/- 11.3 vs. 53.5 +/- 16.1 ml/min; p < 0.01) and distal LAD flow scaled for LV mass (14.3 +/- 5.0 vs. 23.3 +/- 8.5 ml/min/100 g LV mass; p < 0.01). Coronary flow reserve, therefore, increased from 1.76 +/- 0.5 to 2.61 +/- 0.7. CONCLUSIONS Coronary flow reserve increases after AVR for aortic stenosis. This increase occurs in tandem with regression of LV hypertrophy. (C) 2000by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/04/20 alle ore 23:03:40