Microvascular Function in Patients Undergoing Transcatheter Aortic Valve Implant (TAVI) for Severe Symptomatic Aortic Stenosis: Association With Myocardial Fibrosis

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    Matteo Montorfano
Updated on 4 October 2022


Microvascular function in patients undergoing Transcatheter Aortic Valve Implant (TAVI) for severe symptomatic aortic stenosis: association with myocardial fibrosis


Severe symptomatic aortic stenosis is commonly encountered in clinical practice, affecting close to 5% of individuals older than 65 years of age, and carries a dismal prognosis if left untreated.(1,2) Chronically increased left ventricular afterload triggers a compensatory myocardial response, ultimately leading to ventricular hypertrophy, aimed at reducing chronically increased wall tension an restore cardiac performance.(3) Hypertrophy ultimately results in maladaptive changes and ultimately leads to heart failure and eventually increased risk of cardiac mortality. Myocardial fibrosis and altered myocardial perfusion appear to play a role in progressive cardiac decompensation.

Condition Severe Symptomatic Aortic Stenosis
Treatment Coronary Physiology
Clinical Study IdentifierNCT05326126
SponsorMatteo Montorfano
Last Modified on4 October 2022


Yes No Not Sure

Inclusion Criteria

• All patients referred to IRCCS Ospedale San Raffaele who are candidates to receive a TAVI
implant for severe, symptomatic aortic stenosis under current appropriateness criteria and
clinical practice guidelines will be considered eligible to take part in the study

Exclusion Criteria

Age <18 years
Inability to express informed consent to take part in the present study
Pregnancy or lactation
Pre-existing known disease determining a prognosis quo ad vitam shorter than the
follow up of the present study
Significant chronic kidney disease (estimated glomerular filtration rate <30 ml/min)
Known significant epicardial coronary artery stenosis
Known contraindication to adenosine administration
Known allergic reactions
Second or third degree atrioventricular block before the procedure (in absence of a
functional permanent pacemaker)
Long QT syndrome
Unstable angina
Severe hypotension
Acutely decompensated heart failure
Chronic obstructive pulmonary disease with bronchospasm
Concomitant use of dypiridamole
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