ArticleCirculation. Cardiovascular interventions2019
Determining the Predominant Lesion in Patients With Severe Aortic Stenosis and Coronary Stenoses: A Multicenter Study Using Intracoronary Pressure and Flow.
Article in Circulation. Cardiovascular interventions, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Differential Effect of Aortic Valve Replacement for Severe Aortic Stenosis on Hyperemic and Resting Epicardial Coronary Pressure Indices.Journal of the American Heart Association · 2024Pooled it
- Invasive Evaluation of Coronary Artery Disease in Severe Aortic Stenosis-A Narrative Review.Journal of clinical medicine · 2026Review
- Co-Occurrence of Aortic Stenosis and Coronary Artery Disease: Facing Challenges Before, During, and After Transcatheter Aortic Valve Replacement.Journal of clinical medicine · 2025Review
- Coronary Artery Disease and Transcatheter Aortic Valve Replacement.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Review
- Percutaneous Coronary Intervention before or after Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis Involving 1531 Patients.Journal of clinical medicine · 2024Review
- How to address the coronaries in TAVI candidates: can the need for revascularization be safely determined by CT angiography only?European heart journal. Imaging methods and practice · 2024Review
- Contemporary Use of Coronary Physiology in Cardiology.Cardiology and therapy · 2023Review
- Comparison of different percutaneous revascularisation timing strategies in patients undergoing transcatheter aortic valve implantation.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Article
- Invasive Functional Assessment of Coronary Artery Disease in Patients with Severe Aortic Stenosis in the TAVI Era.Journal of clinical medicine · 2023Review
- Management of coronary artery disease in patients undergoing transcatheter aortic valve implantation. A clinical consensus statement from the European Association of Percutaneous Cardiovascular Interventions in collaboration with the ESC Working Group on Cardiovascular Surgery.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Article
- Quantitative flow ratio-based outcomes in patients undergoing transcatheter aortic valve implantation quaestio study.Frontiers in cardiovascular medicine · 2023Article
- Serial changes of coronary flow reserve over one year after transcatheter aortic valve implantation in patients with severe aortic stenosis.International journal of cardiology. Heart & vasculature · 2022Article
- Coronary Physiology: Delivering Precision Medicine?Reviews in cardiovascular medicine · 2022Review
- Aortic Valve Disease and Associated Complex CAD: The Interventional Approach.Journal of clinical medicine · 2021Review
- Determining the Significance of Coronary Plaque Lesions: Physiological Stenosis Severity and Plaque Characteristics.Journal of clinical medicine · 2020Review
- Overview of Quantitative Flow Ratio and Optical Flow Ratio in the Assessment of Intermediate Coronary Lesions.US cardiology · 2020Review
- How to select patients requiring coronary revascularisation using coronary physiology.JRSM cardiovascular diseaseReview
Corrections and comments
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Authors and funding
40 authors at 9 institutions in 7 countries.
Funding
Abstract
backgroundPatients with severe aortic stenosis (AS) often have coronary artery disease. Both the aortic valve and the coronary disease influence the blood flow to the myocardium and its ability to respond to stress; leading to exertional symptoms. In this study, we aim to quantify the effect of severe AS on the coronary microcirculation and determine if this is influenced by any concomitant coronary disease. We then compare this to the effect of coronary stenoses on the coronary microcirculation.
methodsGroup 1: 55 patients with severe AS and intermediate coronary stenoses treated with transcatheter aortic valve implantation (TAVI) were included. Group 2: 85 patients with intermediate coronary stenoses and no AS treated with percutaneous coronary intervention were included. Coronary pressure and flow were measured at rest and during hyperemia in both groups, before and after TAVI (group 1) and before and after percutaneous coronary intervention (group 2).
resultsMicrovascular resistance over the wave-free period of diastole increased significantly post-TAVI (pre-TAVI, 2.71±1.4 mm Hg·cm·s
conclusionsTAVI improves microcirculatory function regardless of the severity of underlying coronary disease. TAVI for severe AS produces a coronary hemodynamic improvement equivalent to the hemodynamic benefit of stenting coronary stenoses with instantaneous wave-free ratio values <0.74. Future trials of physiology-guided revascularization in severe AS may consider using this value to guide treatment of concomitant coronary artery disease.
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