Reduced Myocardial Flow Reserve in Exertional Angina With Severe Aortic Stenosis and Normal Coronary Arteries: Insight From Prospective Observational Adenosine-stress Cardiac Magnetic Resonance Imaging Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 104
- 主要终点
- Values of the myocardial perfusion reserve index (MPRI)
研究概览
简要总结
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.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •normal LV ejection fraction (EF ≥ 50%)
排除标准
- •LVEF < 50% in echocardiography
- •concomitant other valvular disease of moderate or severe severity
- •previous aortic valve replacement
- •symptomatic patients other than chest pain
- •obstructive CAD (>30% luminal stenosis in at least one coronary artery on coronary angiography)
- •history of myocardial infarction or acute coronary syndrome
- •contraindication to adenosine
- •any absolute contraindication to CMR
- •estimated glomerular filtration rate <30 mL/min/1.73m2.
结局指标
主要结局
Values of the myocardial perfusion reserve index (MPRI)
时间窗: 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.
次要结局
未报告次要终点