Coronary microcirculatory dysfunction in aortic stenosis

K. Rajappan, O. Rimoldi, D. J. Pennell, P. G. Camici, D. J. Sheridan

Research output: Chapter in Book/Report/Conference proceedingConference contribution


Development of left ventricular hypertrophy (LVH) in aortic stenosis (AS) is accompanied by dysfunction of the coronary microcirculation, demonstrated by an impaired coronary vasodilator reserve (CVR), but the relative contribution of LVH and changes in haemodynamics remains unclear. In twenty patients with AS, an increase in resting myocardial blood flow (MBF), assessed with positron emission tomography, was demonstrated, proportional to hypertrophy measured with cardiac magnetic resonance, presumably as a result of coronary autoregulation. However, an inverse relationship between CVR and echocardiographic peak transvalvular pressure gradient and left ventricular pressure multiplied by heart rate (LVRPP) suggests that the effect of haemodynamic and intramural forces may be to counteract autoregulation, maintaining transmural MBF at rest, but impairing the coronary microcirculation stress response, particularly within the subendocardium.

Original languageEnglish
Title of host publicationComputers in Cardiology
Number of pages4
Publication statusPublished - 2001
EventComputer in Cardiology 2001 - Rotterdam, Netherlands
Duration: Sep 23 2001Sep 26 2001


OtherComputer in Cardiology 2001

ASJC Scopus subject areas

  • Software
  • Cardiology and Cardiovascular Medicine


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