Incidence and severity of atherosclerotic cardiovascular artery disease in patients undergoing TAVI

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• 作者：Laura Fusini ; Oana Mirea ; Gloria Tamborini…
• 关键词：Transcatheter aortic valve implantation ; Aortic stenosis ; Atherosclerosis ; Cardiovascular imaging
• 刊名：The International Journal of Cardiovascular Imaging (formerly Cardiac Imaging)
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：31
• 期：5
• 页码：975-985
• 全文大小：975 KB
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• 作者单位：Laura Fusini (1)
  Oana Mirea (2)
  Gloria Tamborini (1)
  Manuela Muratori (1)
  Paola Gripari (1)
  Claudia Cefalù (1)
  Sarah Ghulam Ali (1)
  Francesco Maffessanti (1)
  Daniele Andreini (1) (3)
  Gianluca Pontone (1)
  Antonio L. Bartorelli (1) (3)
  Francesco Alamanni (1) (3)
  Marco Agrifoglio (1) (3)
  Mauro Pepi (1)
  
  1. Centro Cardiologico Monzino IRCCS, Milan, Italy
  2. Department of Cardiology, Emergency County Hospital Craiova, Craiova, Romania
  3. Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  
• 出版者：Springer Netherlands
• ISSN：1573-0743

文摘

Transcatheter aortic valve implantation (TAVI) has extended the treatment options for severe, symptomatic aortic valve stenosis (AS). Risk factors for AS have been shown to be similar to atherosclerosis. Consequently, coronary artery disease (CAD), peripheral vascular and carotid artery diseases are often found concurrently with diagnostic, procedural and prognostic implications. This study sought to describe comprehensive vascular assessment in terms of prevalence, severity and correlations in TAVI candidates. A total of 323 patients (81?±?6?years) undergoing TAVI were enrolled. Vascular pathologies were evaluated by invasive coronary angiography, computer-tomography (abdominal aorta, renal, iliac and femoral arteries), echo-color Doppler ultrasound (carotid artery), and transoesophageal echocardiography (thoracic aorta). CAD was found in 173 (54?%) patients, of which 65 (38?%) had 1-vessel, 45 (26?%) 2-vessel and 59 (34?%) 3-vessel disease. Carotid artery disease was present in 33.6?% patients, of which 23.6?% unilateral and 10.0?% bilateral. Iliac, femoral and renal stenosis were found in 29.2 %, 22.0 %, and 4.7?%, respectively. Cardiovascular risk factor and gender correlated with CAD. CAD patients presented more frequently with significant stenosis (luminal narrowing ?0?%) of at least one other district. Multi-districts significant stenosis stratified patients on long-term survival and the coexistence of 3-districts involvement with CAD negatively impacts on mortality. Multimodality imaging assessment shows that coronary, carotid, and peripheral artery disease are often found concurrently in patients undergoing TAVI. Several risk factors and gender correlate with the presence and severity of CAD and peripheral pathologies. Long-term mortality is increased in patients with a more compromised vascular situation.