Long term effects of surgical and transcatheter aortic valve replacement on FFRCT in patients with severe aortic valve stenosis

Vincent Michiels, Daniele Andreini, Edoardo Conte, Kaoru Tanaka, Dries Belsack, Jan Nijs, Ines Van Loo, Jean Francois Argacha, Bert Vandeloo, Bram Roosens, Karen Vandenbussche, Bernard Cosyns

Research output: Contribution to journalArticlepeer-review

Abstract

The long-term variations of fractional flow reserve derived from coronary computed tomography (FFRCT) after surgical (SAVR) or transcatheter (TAVR) aortic valve replacement in patients with severe aortic valve stenosis (AS) have not been investigated. A total of 25 patients with isolated, severe AS underwent coronary computed tomography with 3-vessel FFRCT analysis (Heartflow Inc.-Redwood City, California, USA) and measurement of total coronary volume (V), left ventricular mass (M) and their ratio (V/M) before and 6 months after SAVR or TAVR. A significant increase in V/M due to a decrease in left ventricular mass 6 months after intervention was observed, whereas total coronary volume did not change (coronary volume pre: 2924.5 ± 867.9 mm3, coronary volume post: 2844.2 ± 792.8 mm3, P = 0.158; LV mass pre: 151.7 ± 40.7 g, LV mass post: 127.3 ± 34.7 g, P < 0.001; V/M pre: 19.5 ± 4.1 mm3/g, V/M post: 22.7 ± 4.28 mm3/g, P = 0.002). FFRCT (expressed as area under the virtual pullback curve) remained constant. This proof-of-concept study showed that FFRCT was not subject to the confounding effect of left ventricular mass regression after SAVR or TAVR. Despite significant left ventricular remodeling at 6 months after AS treatment, FFRCT values remained constant. Further studies are needed comparing the performance of the different invasive and non-invasive coronary physiological indices in this patient cohort.

Original languageEnglish
Pages (from-to)427-434
Number of pages8
JournalThe International Journal of Cardiovascular Imaging
Volume38
Issue number2
DOIs
Publication statusPublished - Feb 2022

Bibliographical note

© 2021. The Author(s), under exclusive licence to Springer Nature B.V.

Keywords

  • Aortic stenosis
  • Cardiac computed tomography
  • Coronary physiology

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