Incidence and severity of atherosclerotic cardiovascular artery disease in patients undergoing TAVI

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11 Citations (Scopus)

Abstract

Transcatheter aortic valve implantation (TAVI) has extended the treatment options for severe, symptomatic aortic valve stenosis (AS). Risk factors for AS have been shown to be similar to atherosclerosis. Consequently, coronary artery disease (CAD), peripheral vascular and carotid artery diseases are often found concurrently with diagnostic, procedural and prognostic implications. This study sought to describe comprehensive vascular assessment in terms of prevalence, severity and correlations in TAVI candidates. A total of 323 patients (81 ± 6 years) undergoing TAVI were enrolled. Vascular pathologies were evaluated by invasive coronary angiography, computer-tomography (abdominal aorta, renal, iliac and femoral arteries), echo-color Doppler ultrasound (carotid artery), and transoesophageal echocardiography (thoracic aorta). CAD was found in 173 (54 %) patients, of which 65 (38 %) had 1-vessel, 45 (26 %) 2-vessel and 59 (34 %) 3-vessel disease. Carotid artery disease was present in 33.6 % patients, of which 23.6 % unilateral and 10.0 % bilateral. Iliac, femoral and renal stenosis were found in 29.2 %, 22.0 %, and 4.7 %, respectively. Cardiovascular risk factor and gender correlated with CAD. CAD patients presented more frequently with significant stenosis (luminal narrowing ≥50 %) of at least one other district. Multi-districts significant stenosis stratified patients on long-term survival and the coexistence of 3-districts involvement with CAD negatively impacts on mortality. Multimodality imaging assessment shows that coronary, carotid, and peripheral artery disease are often found concurrently in patients undergoing TAVI. Several risk factors and gender correlate with the presence and severity of CAD and peripheral pathologies. Long-term mortality is increased in patients with a more compromised vascular situation.

Original languageEnglish
Pages (from-to)975-985
Number of pages11
JournalInternational Journal of Cardiovascular Imaging
Volume31
Issue number5
DOIs
Publication statusPublished - Mar 25 2015

Fingerprint

Coronary Artery Disease
Cardiovascular Diseases
Arteries
Incidence
Carotid Artery Diseases
Blood Vessels
Pathologic Constriction
Peripheral Arterial Disease
Aortic Valve Stenosis
Pathology
Doppler Ultrasonography
Mortality
Iliac Artery
Abdominal Aorta
Transesophageal Echocardiography
Renal Artery
Femoral Artery
Thigh
Transcatheter Aortic Valve Replacement
Coronary Angiography

Keywords

  • Aortic stenosis
  • Atherosclerosis
  • Cardiovascular imaging
  • Transcatheter aortic valve implantation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{5fce9c763bfa4379b9274256e2bd33c7,
title = "Incidence and severity of atherosclerotic cardiovascular artery disease in patients undergoing TAVI",
abstract = "Transcatheter aortic valve implantation (TAVI) has extended the treatment options for severe, symptomatic aortic valve stenosis (AS). Risk factors for AS have been shown to be similar to atherosclerosis. Consequently, coronary artery disease (CAD), peripheral vascular and carotid artery diseases are often found concurrently with diagnostic, procedural and prognostic implications. This study sought to describe comprehensive vascular assessment in terms of prevalence, severity and correlations in TAVI candidates. A total of 323 patients (81 ± 6 years) undergoing TAVI were enrolled. Vascular pathologies were evaluated by invasive coronary angiography, computer-tomography (abdominal aorta, renal, iliac and femoral arteries), echo-color Doppler ultrasound (carotid artery), and transoesophageal echocardiography (thoracic aorta). CAD was found in 173 (54 {\%}) patients, of which 65 (38 {\%}) had 1-vessel, 45 (26 {\%}) 2-vessel and 59 (34 {\%}) 3-vessel disease. Carotid artery disease was present in 33.6 {\%} patients, of which 23.6 {\%} unilateral and 10.0 {\%} bilateral. Iliac, femoral and renal stenosis were found in 29.2 {\%}, 22.0 {\%}, and 4.7 {\%}, respectively. Cardiovascular risk factor and gender correlated with CAD. CAD patients presented more frequently with significant stenosis (luminal narrowing ≥50 {\%}) of at least one other district. Multi-districts significant stenosis stratified patients on long-term survival and the coexistence of 3-districts involvement with CAD negatively impacts on mortality. Multimodality imaging assessment shows that coronary, carotid, and peripheral artery disease are often found concurrently in patients undergoing TAVI. Several risk factors and gender correlate with the presence and severity of CAD and peripheral pathologies. Long-term mortality is increased in patients with a more compromised vascular situation.",
keywords = "Aortic stenosis, Atherosclerosis, Cardiovascular imaging, Transcatheter aortic valve implantation",
author = "Laura Fusini and Oana Mirea and Gloria Tamborini and Manuela Muratori and Paola Gripari and Claudia Cefal{\`u} and {Ghulam Ali}, Sarah and Francesco Maffessanti and Daniele Andreini and Gianluca Pontone and Bartorelli, {Antonio L.} and Francesco Alamanni and Marco Agrifoglio and Mauro Pepi",
year = "2015",
month = "3",
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doi = "10.1007/s10554-015-0651-9",
language = "English",
volume = "31",
pages = "975--985",
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T1 - Incidence and severity of atherosclerotic cardiovascular artery disease in patients undergoing TAVI

AU - Fusini, Laura

AU - Mirea, Oana

AU - Tamborini, Gloria

AU - Muratori, Manuela

AU - Gripari, Paola

AU - Cefalù, Claudia

AU - Ghulam Ali, Sarah

AU - Maffessanti, Francesco

AU - Andreini, Daniele

AU - Pontone, Gianluca

AU - Bartorelli, Antonio L.

AU - Alamanni, Francesco

AU - Agrifoglio, Marco

AU - Pepi, Mauro

PY - 2015/3/25

Y1 - 2015/3/25

N2 - Transcatheter aortic valve implantation (TAVI) has extended the treatment options for severe, symptomatic aortic valve stenosis (AS). Risk factors for AS have been shown to be similar to atherosclerosis. Consequently, coronary artery disease (CAD), peripheral vascular and carotid artery diseases are often found concurrently with diagnostic, procedural and prognostic implications. This study sought to describe comprehensive vascular assessment in terms of prevalence, severity and correlations in TAVI candidates. A total of 323 patients (81 ± 6 years) undergoing TAVI were enrolled. Vascular pathologies were evaluated by invasive coronary angiography, computer-tomography (abdominal aorta, renal, iliac and femoral arteries), echo-color Doppler ultrasound (carotid artery), and transoesophageal echocardiography (thoracic aorta). CAD was found in 173 (54 %) patients, of which 65 (38 %) had 1-vessel, 45 (26 %) 2-vessel and 59 (34 %) 3-vessel disease. Carotid artery disease was present in 33.6 % patients, of which 23.6 % unilateral and 10.0 % bilateral. Iliac, femoral and renal stenosis were found in 29.2 %, 22.0 %, and 4.7 %, respectively. Cardiovascular risk factor and gender correlated with CAD. CAD patients presented more frequently with significant stenosis (luminal narrowing ≥50 %) of at least one other district. Multi-districts significant stenosis stratified patients on long-term survival and the coexistence of 3-districts involvement with CAD negatively impacts on mortality. Multimodality imaging assessment shows that coronary, carotid, and peripheral artery disease are often found concurrently in patients undergoing TAVI. Several risk factors and gender correlate with the presence and severity of CAD and peripheral pathologies. Long-term mortality is increased in patients with a more compromised vascular situation.

AB - Transcatheter aortic valve implantation (TAVI) has extended the treatment options for severe, symptomatic aortic valve stenosis (AS). Risk factors for AS have been shown to be similar to atherosclerosis. Consequently, coronary artery disease (CAD), peripheral vascular and carotid artery diseases are often found concurrently with diagnostic, procedural and prognostic implications. This study sought to describe comprehensive vascular assessment in terms of prevalence, severity and correlations in TAVI candidates. A total of 323 patients (81 ± 6 years) undergoing TAVI were enrolled. Vascular pathologies were evaluated by invasive coronary angiography, computer-tomography (abdominal aorta, renal, iliac and femoral arteries), echo-color Doppler ultrasound (carotid artery), and transoesophageal echocardiography (thoracic aorta). CAD was found in 173 (54 %) patients, of which 65 (38 %) had 1-vessel, 45 (26 %) 2-vessel and 59 (34 %) 3-vessel disease. Carotid artery disease was present in 33.6 % patients, of which 23.6 % unilateral and 10.0 % bilateral. Iliac, femoral and renal stenosis were found in 29.2 %, 22.0 %, and 4.7 %, respectively. Cardiovascular risk factor and gender correlated with CAD. CAD patients presented more frequently with significant stenosis (luminal narrowing ≥50 %) of at least one other district. Multi-districts significant stenosis stratified patients on long-term survival and the coexistence of 3-districts involvement with CAD negatively impacts on mortality. Multimodality imaging assessment shows that coronary, carotid, and peripheral artery disease are often found concurrently in patients undergoing TAVI. Several risk factors and gender correlate with the presence and severity of CAD and peripheral pathologies. Long-term mortality is increased in patients with a more compromised vascular situation.

KW - Aortic stenosis

KW - Atherosclerosis

KW - Cardiovascular imaging

KW - Transcatheter aortic valve implantation

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