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• W2051296709 abstract "Aim: Patients with moderate and severe aortic stenosis ( AS ) and without obstructive epicardial coronary disease have been shown to have an impairment of coronary flow reserve ( CFR ). We investigated the prognostic significance of CFR in predicting death during mid‐to‐long‐term follow‐up in asymptomatic patients with moderate/severe AS , preserved ejection fraction ( EF ), and with nonobstructed coronary arteries. Method and Result: A total of 127 patients with moderate or severe AS (effective orifice area of 1.5 cm 2 or less), mean age 66 ± 11 were enrolled in this prospective study. The median follow‐up was 32 ± 7 months. All patients had standard Doppler echo study, coronary angiography, and adenosine‐stress transthoracic Doppler echo for CFR measurement. Univariate analysis showed that diabetes mellitus, CFR , aortic valve area ( AVA ), maximal velocity (V max ), mean pressure gradient (P mean ), energy loss index ( ELI ), aortic valve resistance ( AVR ), NT‐proBNP, E/E′, valvulo‐arterial impedance (Z va ), and stroke work loss ( SWL ) were associated (P < 0.05) with death. Multivariable logistic regression analysis revealed that only Z va and CFR were independent predictors of death, with the CFR being the single strongest predictor (Table 2). Using receiver operating characteristics ( ROC ) analysis, the CFR value of 1.85 had the highest accuracy in predicting the death during mid‐to‐long‐term follow‐up (area under the curve; AUC 0.890, P = 0.009, sensitivity 96.3%, specificity 75%; 95% CI 0.287–0.946; Fig. 1). The Z va value of 5.52 Hg/mL per m had a sensitivity 70.0% and specificity 72.0% ( AUC 0.766, 95% CI 0.587–0.946; P = 0.005). Conclusion: This study demonstrates that CFR has a prognostic value in patients with asymptomatic moderate or severe AS with preserved EF and nonobstructed coronary arteries." @default.
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• W2051296709 date "2013-10-24" @default.
• W2051296709 modified "2023-09-27" @default.
• W2051296709 title "Prognostic Value of Coronary Flow Reserve in Asymptomatic Moderate or Severe Aortic Stenosis with Preserved Ejection Fraction and Nonobstructed Coronary Arteries" @default.
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• W2051296709 doi "https://doi.org/10.1111/echo.12404" @default.
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