Angina pectoris in patients with aortic stenosis and normal coronary arteries. Mechanisms and pathophysiological concepts
Details
Serval ID
serval:BIB_A1BD3854254A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Angina pectoris in patients with aortic stenosis and normal coronary arteries. Mechanisms and pathophysiological concepts
Journal
Circulation
ISSN
0009-7322 (Print)
Publication state
Published
Issued date
02/1997
Volume
95
Number
4
Pages
892-8
Notes
Comparative Study
Journal Article --- Old month value: Feb 18
Journal Article --- Old month value: Feb 18
Abstract
BACKGROUND: The incidence of angina pectoris (AP) in patients with severe aortic stenosis (AS) and normal coronary arteries has been reported to be 30% to 40%. The exact pathophysiological mechanism, however, is not known. The purpose of this work was to evaluate the various hemodynamic and angiographic determinants of myocardial perfusion in 61 patients with severe AS. METHODS AND RESULTS: In a retrospective analysis, 61 patients with severe AS and without significant coronary artery disease were studied. Thirty-three patients with atypical chest pain and angiographically normal arteries served as control subjects. Patients were divided into two groups: 32 with AP and 29 without AP. Quantitative coronary angiography was performed in 59 patients and 22 control subjects. Coronary flow reserve was determined in 29 patients and 7 control subjects by use of coronary sinus thermodilution technique. Patients with AP had a lower left ventricular (LV) muscle mass, an increased LV peak systolic pressure, and increased wall stress than those without AP. Vessels of the left coronary artery were smaller and coronary flow reserve was lower in patients with AP than in those without. Inadequate L V hypertrophy with an increased wall stress was found in patients with AP but not in patients without AP. CONCLUSIONS: Myocardial ischemia in patients with severe AS can occur in the absence of coronary artery disease and appears to be due to inadequate LV hypertrophy with high systolic and diastolic wall stresses and a reduced coronary flow reserve. The cause of inadequate LV hypertrophy, however, remains unclear.
Keywords
Adult
Aged
Aged, 80 and over
Angina Pectoris/complications/*physiopathology/radiography
Aortic Valve Stenosis/complications/*physiopathology/radiography
Coronary Angiography
Coronary Circulation
Coronary Vessels/*physiology/physiopathology
Diastole
Heart Catheterization
Heart Rate
*Hemodynamic Processes
Humans
Middle Aged
Myocardial Ischemia/*physiopathology/radiography
Reference Values
Regression Analysis
Retrospective Studies
Systole
Pubmed
Web of science
Create date
28/01/2008 10:32
Last modification date
20/08/2019 15:07