ArticleOpen heart2025
Changes in myocardial blood flow and microvascular resistance in patients with coronary artery disease undergoing transcatheter aortic valve implantation.
Article in Open heart, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- How to Individualize Coronary Assessment and Revascularization in Severe AS Patients Undergoing TAVI in the Era of Lifetime Management?Journal of clinical medicine · 2026Review
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Authors and funding
14 authors.
Funding
Abstract
backgroundSevere aortic stenosis (AS) causes a pathophysiological cascade, which impairs myocardial blood flow. This effect is exacerbated in the presence of coronary disease (CAD). Treatment with transcatheter aortic valve implantation (TAVI) may promote reversal of these pathophysiological conditions.
methodsWe performed multimodality assessment of cardiac physiology in patients with AS and concurrent CAD requiring percutaneous coronary intervention, prior to and 6 months after undergoing TAVI. Techniques include: coronary angiography and bolus thermodilution-derived indices of microvascular function (coronary flow reserve (CFR); index of microcirculatory resistance (IMR)); stress perfusion cardiac magnetic resonance (CMR) imaging, which was used to measure changes in global myocardial blood flow (MBF) and left ventricular mass (LVM), and computed resting and hyperaemic vessel specific absolute coronary flow (aCBF) and microvascular resistance (MVR) using a computational model of coronary physiology.
resultsData were obtained for seven patients (10 vessels). CFR increased from 1.53 (1.2-1.7) to 2.35 (2.0-2.7) (p=0.037) 6 months post-TAVI. There was a 33% reduction in resting aCBF from 218 mL/min to 146 mL/min (p=0.004). On CMR, resting MBF fell 37% from 3.0±0.98 mL/min/g to 1.9±0.7 mL/min/g (p=0.033) and stress MBF fell 25% from 3.6±0.57 mL/min/g to 2.7±0.7 mL/min/g (p=0.004). Indexed LVM regressed from 79±14 g/m
conclusionsCFR increased following TAVI. The mechanism for this was a significant reduction in resting coronary blood flow measured with CMR and modelled computationally. The unchanged MVR and IMR suggest that resting blood flow reduces due to reduced myocardial demand and myocardial remodelling, rather than changes in resistance.
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Registered trials
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