The American journal of cardiology

1879-19132142024Mar01The American journal of cardiologyAm J CardiolCoronary Flow Reserve and Myocardial Resistance Reserve Changes After Transcatheter Aortic Valve Implantation in Aortic Stenosis.109114109-11410.1016/j.amjcard.2024.01.005S0002-9149(24)00031-6Aortic valve stenosis (AS) induces an alteration in hemodynamic conditions that are responsible for coronary microvasculature impairment. Relief of AS by transcatheter aortic valve implantation (TAVI) is expected to improve the coronary artery hemodynamic. We aimed to assess the midterm effects of TAVI in coronary flow reserve (CFR) and myocardial resistance reserve (MRR) by a continuous intracoronary thermodilution technique. At-rest and hyperemic coronary flow was measured by a continuous thermodilution technique in 23 patients with AS and compared with that in 17 matched controls, and repeated 6 ± 3 months after TAVI in 11 of the patients with AS. In patients with AS, absolute coronary flow at rest was significantly greater, and absolute resistance at rest was significantly less, than in controls (p <0.01 for both), causing less CFR and MRR (1.73 ± 0.4 vs 2.85 ± 1.1, p <0.01 and 1.95 ± 0.4 vs 3.22 ± 1.4, p <0.01, respectively). TAVI implantation yielded a significant 35% increase in CFR (p >0.01) and a 39% increase in MRR (p <0.01) driven by absolute coronary flow at rest reduction (p = 0.03). In patients with AS, CFR and MRR determined by continuous thermodilution are significantly impaired. At 6-month follow-up, TAVI improves these indexes and partially relieves the pathophysiologic alterations, leading to a partial restoration of CFR and MRR.Copyright © 2024 Elsevier Inc. All rights reserved.Gutiérrez-BarriosAlejandroACardiology Department, Hospital Puerta del Mar, Cádiz, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), University of Cadiz, Cadiz, Spain. Electronic address: aleklos@hotmail.com.Cañadas-PruañoDoloresDCardiology Department, Hospital Puerta del Mar, Cádiz, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), University of Cadiz, Cadiz, Spain.AlfaroLuis MartinLMCardiology Department, Hospital Puerta del Mar, Cádiz, Spain.GheorgheLiviaLCardiology Department, Hospital Puerta del Mar, Cádiz, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), University of Cadiz, Cadiz, Spain.SilvaEtelvinoEInstituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), University of Cadiz, Cadiz, Spain.Noval-MorillasInmaculadaICardiology Department, Hospital Puerta del Mar, Cádiz, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), University of Cadiz, Cadiz, Spain.PinoCarlos Campo-CossioCCCardiology Department, Hospital Puerta del Mar, Cádiz, Spain.RuedaRicardo ZayasRZCardiology Department, Hospital Puerta del Mar, Cádiz, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), University of Cadiz, Cadiz, Spain.Calle-PérezGermánGCardiology Department, Hospital Puerta del Mar, Cádiz, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), University of Cadiz, Cadiz, Spain.Vázquez-GarcíaRafaelRCardiology Department, Hospital Puerta del Mar, Cádiz, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), University of Cadiz, Cadiz, Spain.Toro-CebadaRocioRInstituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), University of Cadiz, Cadiz, Spain.engJournal Article20240115