Abnormal Fractional Flow Reserve and Non-hyperaemic Pressure Ratios in Patients With Severe Aortic Stenosis and Non-obstructive Coronary Artery Disease

Abstract

Fractional flow reserve (FFR) and non-hyperaemic pressure ratios (NHPRs) are well-validated tools that assess the physiological significance of coronary artery disease (CAD). Low coronary lumen to myocardial mass (V/M) ratio is associated with lower FFR and NHPRs, and predisposes towards ischaemia in CAD. Whilst CAD and aortic stenosis (AS) frequently co-exist, patients with both often report angina despite non-obstructive CAD. We therefore sought to study the interrelationship between V/M and invasive pressure indices in abnormal resting physiological states in severe AS.