Myocardial Flow Reserve in Severe AS Without Obstructive Coronary Artery Disease

Samsung Medical Center

Status: Completed

Conditions: Chest Pain; Severe Aortic Stenosis

Treatments: Other: Adenosine-stress cardiac magnetic resonance imaging

Study type: Observational

Funder types: Other

Identifiers

NCT02575768

2012-01-014

Details and patient eligibility

About

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.

Enrollment: 104 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

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.

Trial design

104 participants in 3 patient groups

Severe AS: asymptomatic

Description:

Asymptomatic

Treatment:

Other: Adenosine-stress cardiac magnetic resonance imaging

Severe AS: pure angina

Description:

Presence of exertional chest pain

Treatment:

Other: Adenosine-stress cardiac magnetic resonance imaging

Normal controls

Description:

Healthy controls

Treatment:

Other: Adenosine-stress cardiac magnetic resonance imaging