What does this research mean for the field?

In patients with critical aortic stenosis and angina but no coronary artery disease, cardiac pain is driven by an impaired coronary vascular reserve that restricts energy supply during stress, in addition to increased left ventricular energy demand. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

October 1, 1967CirculationOpen Access

Mechanisms of Angina in Aortic Stenosis

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Why the study?

Does impaired coronary vascular reserve contribute to the mechanism of angina in patients with aortic stenosis during isoproterenol stress?

Population

18 patients with aortic stenosis, divided into Group A, Group B, and Group C.

Comparison

Standard isoproterenol infusion (stress testing) vs Comparison between patient groups based on the…

Design

Cross-sectional

Authors

EFErnest L. FallenSt. Michael's Hospital WEW ELLIOTTSUNY Upstate Medical University RGRichard GorlinAmerican College of Cardiology

Discussion

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Implication

Supports impaired coronary reserve contributing to angina in aortic stenosis; hypothesis-generating and requires prospective validation before practice implications.

Structured PICO

Does impaired coronary vascular reserve contribute to the mechanism of angina in patients with aortic stenosis during isoproterenol stress?

Population

18 patients with aortic stenosis, divided into Group A (without angina or coronary artery disease, n=7), Group B (critical aortic stenosis with angina but no coronary disease, n=5), and Group C (aortic stenosis with angina and coronary artery disease).

Intervention

Standard isoproterenol infusion (stress testing)

Comparator

Comparison between patient groups based on the presence of angina and coronary artery disease

Outcome

Hemodynamic and coronary circulatory changes (coronary flow, myocardial oxygen extraction, myocardial lactate production)surrogate

Angina in pure aortic stenosis is driven not only by increased left ventricular demand but also by impaired coronary vascular reserve and inadequate energy supply during stress.

Cite This Study

Fallen et al. (1967) studied this question.

synapsesocial.com/papers/6a1c18124ebd09f3dfa96e68 https://doi.org/10.1161/01.cir.36.4.480

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Implication

Supports impaired coronary reserve contributing to angina in aortic stenosis; hypothesis-generating and requires prospective validation before practice implications.

Mechanisms of Angina in Aortic Stenosis

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Mechanisms of Angina in Aortic Stenosis

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Also Consider

Also Consider