Aortic valve stenosis is associated with reduced myocardial perfusion as assessed by videodensitometry in coronary angiograms

Abstract

Aortic valve stenosis may be accompanied by angina despite coronary arteries free of significant stenosis due to microvascular abnormalities. The aim of the current study was to test whether densitometry-derived myocardial perfusion on coronary angiogram is reduced in patients with aortic valve stenosis. The study comprised 20 patients with aortic valve stenosis (mean transvalvular gradient: 47.4±15.2 mm Hg) and 30 control subjects without significant epicardial coronary artery stenosis. A quantitative parameter of myocardial perfusion was calculated by the ratio of maximal density (Gmax) and time to reach maximum density (Tmax) on time-density curves in regions of interest of each coronary artery on coronary angiograms. Mean three-vessel Gmax/Tmax proved to be significantly lower in patients with aortic valve stenosis compared to control subjects (2.55±1.02 1/sec vs. 3.39±1.09 1/sec, p<0.01). Reduced Gmax/Tmax values indicative of myocardial perfusion abnormalities as measured by densitometry on coronary angiograms could be demonstrated in patients with aortic valve stenosis compared to controls.