Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Long-Term Changes in Invasive Physiological Pressure Indices of Stenosis Severity Following Transcatheter Aortic Valve Implantation

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Horizontal Aorta in Transcatheter Self-Expanding Valves: Insights From the HORSE International Multicentre Registry

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Transcatheter Aortic Valve Replacement for Degenerated Transcatheter Aortic Valves: The TRANSIT International Project

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Bicuspid Aortic Valve Anatomy and Relationship With Devices: The BAVARD Multicenter Registry

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Microcirculatory Function in Nonhypertrophic and Hypertrophic Myocardium in Patients With Aortic Valve Stenosis

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. CT or Invasive Coronary Angiography in Stable Chest Pain

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Computed Tomography-Based Selection of Transseptal Puncture Site for Percutaneous Left Atrial Appendage Closure

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: Patients with severe aortic stenosis frequently have coexisting coronary artery disease. Invasive hyperemic and nonhyperemic pressure indices are used to assess coronary artery disease severity but have not been evaluated in the context of severe aortic stenosis.

METHODS: We compared lesion reclassification rates of fractional flow reserve (FFR) and resting full-cycle ratio (RFR) measured before and 6 months after transcatheter aortic valve implantation using the conventional clinical cutoffs of ≤0.80 for FFR and ≤0.89 for RFR. This was a substudy of the ongoing NOTION-3 trial (Third Nordic Aortic Valve Intervention). Two-dimensional quantitative coronary analysis was used to assess changes in angiographic lesion severity.

RESULTS: Forty patients were included contributing 50 lesions in which FFR was measured. In 32 patients (36 lesions), RFR was also measured. There was no significant change in diameter stenosis from baseline to follow-up, 49.8% (42.9%-57.1%) versus 52.3% (43.2%-57.8%), P=0.50. RFR improved significantly from 0.88 (0.83%-0.93) at baseline to 0.92 (0.83-0.95) at follow-up, P=0.003, whereas FFR remained unchanged, 0.84 (0.81-0.89) versus 0.86 (0.78-0.90), P=0.72. At baseline, 11 out of 50 (22%) lesions were FFR-positive, whereas 15 out of 50 (30%) were positive at follow-up, P=0.219. Corresponding numbers for RFR were 23 out of 36 (64%) at baseline and 12 out of 36 (33%) at follow-up, P=0.003.

CONCLUSIONS: In patients with severe aortic stenosis, physiological assessment of coronary lesions with FFR before transcatheter aortic valve implantation leads to lower reclassification rate at 6-month follow-up, compared with RFR.

Original languageEnglish
JournalCirculation. Cardiovascular interventions
Volume15
Issue number1
Pages (from-to)e011331
ISSN1941-7640
DOIs
Publication statusPublished - Jan 2022

ID: 71203653