Chest Pain, Severe Aortic Stenosis
Conditions
Brief summary
Exertional angina is common symptom in patients with severe aortic stenosis (AS) without obstructive coronary artery disease (CAD). Although reduced myocardial flow reserve is one of the proposed explanations for angina, little is known about the pathophysiology. This study aimed that adenosine-stress cardiac magnetic resonance can be used for the assessment of myocardial perfusion reserve and suggest the pathophysiology of development of angina in patients with severe AS without obstructive CAD.
Interventions
OTHERAdenosine-stress cardiac magnetic resonance imaging
undergoing adenosine-stress cardiac magnetic resonance imaging
Sponsors
Samsung Medical Center
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. severe AS 2. normal LV ejection fraction (EF ≥ 50%)
Exclusion criteria
1. age \<18 2. LVEF \< 50% in echocardiography 3. concomitant other valvular disease of moderate or severe severity 4. previous aortic valve replacement 5. symptomatic patients other than chest pain 6. obstructive CAD (\>30% luminal stenosis in at least one coronary artery on coronary angiography) 7. history of myocardial infarction or acute coronary syndrome 8. contraindication to adenosine 9. any absolute contraindication to CMR 10. estimated glomerular filtration rate \<30 mL/min/1.73m2.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Values of the myocardial perfusion reserve index (MPRI) | Day 1 | Signal intensity-time curves were generated for all segments and the maximum upslope of the LV myocardium divided by the maximum upslope of the LV cavity. MPRI \[upslopestress(corrected)/upsloperest(corrected)\] was calculated dividing the segmental upslope value during adenosine and rest. Whole (average of all myocardial segments) MPRI were calculated. |
Outcome results
None listed