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Silent coronary artery disease in asymptomatic patients with severe aortic stenosis and normal exercise testing

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F20%3A00079437" target="_blank" >RIV/00023001:_____/20:00079437 - isvavai.cz</a>

  • Result on the web

    <a href="https://journals.lww.com/coronary-artery/Abstract/2020/03000/Silent_coronary_artery_disease_in_asymptomatic.10.aspx" target="_blank" >https://journals.lww.com/coronary-artery/Abstract/2020/03000/Silent_coronary_artery_disease_in_asymptomatic.10.aspx</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.1097/MCA.0000000000000801" target="_blank" >10.1097/MCA.0000000000000801</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Silent coronary artery disease in asymptomatic patients with severe aortic stenosis and normal exercise testing

  • Original language description

    OBJECTIVE: There are no data about the prevalence of silent coronary artery disease in asymptomatic severe aortic stenosis patients with normal exercise testing. Importantly, unmasking significant coronary artery disease in patients with aortic stenosis could influence the choice/timing of treatment in these patients. METHOD: Exercise testing was performed on semi-supine ergobicycle. Cardiopulmonary analysis during exercise testing, echocardiography, and laboratory analysis at rest was done. Standard clinical/electrocardiography criteria were assessed for symptoms/signs of ischemia during/after exercise testing. In patients with normal exercise testing coronary angiography was performed using standard femoral/radial percutaneous approach. Coronary stenosis was considered significant if &gt;70% of vessel diameter or 50%-70% with fractional flow reserve ≤0.8. RESULTS: Total of 96 patients with normal exercise testing were included (67.6 years, 50.6% males). No patient had any complication or adverse event. The Pmean was 52.7 mmHg, mean indexed aortic valve area was 0.36 cm/m and left ventricular ejection fraction, 69.5%. 19/96 patients (19.8%) had significant coronary artery disease on coronary angiography. Multivariate logistic regression analysis revealed brain natriuretic peptide and blood glucose as independent predictors of silent coronary artery disease. Brain natriuretic peptide value of 118 pg/ml had sensitivity/specificity of 63%/73% for predicting coronary artery disease (area under the curve 0.727, P = 0.006). CONCLUSION: Our results are the first to show that in patients with severe aortic stenosis, normal left ventricular ejection fraction,, and normal exercise testing, significant coronary artery disease is present in as many as 1/5 patients. In such patients, further prospective studies are warranted to address the diagnostic value of brain natriuretic peptide in detecting silent coronary artery disease.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30201 - Cardiac and Cardiovascular systems

Result continuities

  • Project

  • Continuities

    N - Vyzkumna aktivita podporovana z neverejnych zdroju

Others

  • Publication year

    2020

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    Coronary artery disease

  • ISSN

    0954-6928

  • e-ISSN

  • Volume of the periodical

    31

  • Issue of the periodical within the volume

    2

  • Country of publishing house

    US - UNITED STATES

  • Number of pages

    8

  • Pages from-to

    166-173

  • UT code for WoS article

    000536186200010

  • EID of the result in the Scopus database

    2-s2.0-85078815322