Is the coronary flow velocity reserve improvement after aortic valve replacement for aortic stenosis transient? Results of a 3-year follow-up

Attila Nemes, T. Forster, Zsolt Kovács, M. Csanády

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

The coronary flow velocity reserve (CFR) is decreased in patients with aortic valve stenosis (AS). The aim of the present prospective study was to examine the CFR in AS patients with normal epicardial coronary arteries during a 3-year follow-up of aortic valve replacement (AVR). A total of 30 AS patients (17 women and 13 men) were enrolled in this prospective follow-up study; they all had a normal coronary angiogram and underwent dipyridamole stress transesophageal echocardiography (STEE) for CFR measurement before AVR. Nine of them participated in this 3-year follow-up study, and all patients were examined 16 months and 3 years after AVR by STEE. The CFR of AS patients was decreased before AVR. Different extents of diastolic coronary flow velocity reduction (resting and posthyperaemic) were observed resulting in a significant CFR improvement, despite the low number of patients during the 16-month follow-up. A further posthyperemic flow velocity reduction was demonstrated after the 3-yearfollow-up, resulting in a significant CFR impairment. The CFR decreased in 5 cases, but remained practically unchanged in 3 after the first CFR measurement; only the CFR of 1 patient improved minimally. The main finding of the current study is that the CFR improvement 16 months after AVR, which paralleled the regression of the left ventricular hypertrophy, was found to be transient. Coronary flow velocity reserve impairment was demonstrated after the long-term (3-year) follow-up in most of the patients, which could not be explained by extravascular compressive forces.

Original languageEnglish
Pages (from-to)157-161
Number of pages5
JournalHeart and Vessels
Volume21
Issue number3
DOIs
Publication statusPublished - May 2006

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Aortic Valve Stenosis
Aortic Valve
Stress Echocardiography
Transesophageal Echocardiography
Dipyridamole
Left Ventricular Hypertrophy
Coronary Vessels
Angiography
Prospective Studies

Keywords

  • Aortic valve replacement
  • Aortic valve stenosis
  • Coronary flow
  • Transesophageal echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Is the coronary flow velocity reserve improvement after aortic valve replacement for aortic stenosis transient? Results of a 3-year follow-up. / Nemes, Attila; Forster, T.; Kovács, Zsolt; Csanády, M.

In: Heart and Vessels, Vol. 21, No. 3, 05.2006, p. 157-161.

Research output: Contribution to journalArticle

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AB - The coronary flow velocity reserve (CFR) is decreased in patients with aortic valve stenosis (AS). The aim of the present prospective study was to examine the CFR in AS patients with normal epicardial coronary arteries during a 3-year follow-up of aortic valve replacement (AVR). A total of 30 AS patients (17 women and 13 men) were enrolled in this prospective follow-up study; they all had a normal coronary angiogram and underwent dipyridamole stress transesophageal echocardiography (STEE) for CFR measurement before AVR. Nine of them participated in this 3-year follow-up study, and all patients were examined 16 months and 3 years after AVR by STEE. The CFR of AS patients was decreased before AVR. Different extents of diastolic coronary flow velocity reduction (resting and posthyperaemic) were observed resulting in a significant CFR improvement, despite the low number of patients during the 16-month follow-up. A further posthyperemic flow velocity reduction was demonstrated after the 3-yearfollow-up, resulting in a significant CFR impairment. The CFR decreased in 5 cases, but remained practically unchanged in 3 after the first CFR measurement; only the CFR of 1 patient improved minimally. The main finding of the current study is that the CFR improvement 16 months after AVR, which paralleled the regression of the left ventricular hypertrophy, was found to be transient. Coronary flow velocity reserve impairment was demonstrated after the long-term (3-year) follow-up in most of the patients, which could not be explained by extravascular compressive forces.

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