| Angina pectoris in patients with aortic stenosis and normal coronary arteries. Mechanisms and pathophysiological concepts. | |
| | |
MedLine Citation:
|
PMID: 9054747 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
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. |
| | |
Authors:
|
B K Julius; M Spillmann; G Vassalli; B Villari; F R Eberli; O M Hess |
Related Documents
:
|
1977857 - The coronary hemodynamics and left ventricular function in patients with compensated hy... 3806927 - Age-related changes in right and left ventricular function in tetralogy of fallot. 8370237 - Variability of digitized left ventricular m-mode echocardiography: a study in healthy s... 7982417 - Na,k-pump concentration in hypertrophied human hearts. 7987877 - Efficacy of pulmonary artery banding in the prevention of pulmonary vascular obstructiv... 14716597 - Qt variability. |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Circulation Volume: 95 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1997 Feb |
Date Detail:
|
Created Date: 1997-04-03 Completed Date: 1997-04-03 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 892-8 Citation Subset: AIM; IM |
Affiliation:
|
Division of Cardiology, University Hospital, Zurich, Switzerland. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
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 Hemodynamics* Humans Middle Aged Myocardial Ischemia / physiopathology*, radiography Reference Values Regression Analysis Retrospective Studies Systole |
| Comments/Corrections | |
Comment In:
|
Circulation. 1997 Feb 18;95(4):790-2
[PMID:
9054730
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Platelet activation by superoxide anion and hydroxyl radicals intrinsically generated by platelets t...
Next Document: Time-related changes in left ventricular function after double valve replacement for combined aortic...