November 25, 1982New England Journal of Medicine
Decreased Coronary Reserve
Key result
The ratio of peak to resting coronary blood flow velocity was decreased by more than 50% (P<0.05) in patients with aortic stenosis and left ventricular hypertrophy compared to controls.
Why the study?
Is coronary reserve decreased in patients with aortic stenosis and left ventricular hypertrophy compared to controls without left ventricular hypertrophy?
Population
14 patients with aortic stenosis and left ventricular hypertrophy undergoing elective open-heart surgery…
Comparison
Measurement of maximal velocity of coronary… vs 8 controls without left ventricular hypertrophy.
Design
Case-control
Authors
Discussion
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Implication
May contribute to angina in aortic stenosis with LVH; leaves open causal confirmation and intervention trials.
Study Design
Type
Observational (n=22)
Structured PICO
Is coronary reserve decreased in patients with aortic stenosis and left ventricular hypertrophy compared to controls without left ventricular hypertrophy?
P
Population
14 patients with aortic stenosis and left ventricular hypertrophy (13 had angina) undergoing elective open-heart surgery, and 8 controls without left ventricular hypertrophy (total n=22).
I
Intervention
Measurement of maximal velocity of coronary blood flow in the left-anterior descending coronary artery using a specially designed Doppler probe after a 20-second occlusion.
C
Comparator
8 controls without left ventricular hypertrophy.
O
Outcome
Ratio of peak velocity of coronary blood flow after a 20-second occlusion to resting velocity (coronary reserve).surrogate
Main Result
p-value: p=<0.05
Patients with severe aortic stenosis and left ventricular hypertrophy have a marked decrease in coronary reserve, which likely contributes to the pathogenesis of angina pectoris despite normal coronary arteries.
Cite This Study
Marcus et al. (1982) conducted an observational in Aortic stenosis and left ventricular hypertrophy (n=22). Measurement of maximal velocity of coronary blood flow vs. Controls without left ventricular hypertrophy was evaluated on Ratio of peak velocity of coronary blood flow after a 20-second occlusion to resting velocity (p=<0.05). The ratio of peak to resting coronary blood flow velocity was decreased by more than 50% (P<0.05) in patients with aortic stenosis and left ventricular hypertrophy compared to controls.