Aortic Valve Disease Effect On The Coronary Hemodynamics

Objective:Using TIMI frame count method of coronary angiography,to approach the effect of Aortic valve disease to hemodynamic of the coronary artery,and to provi- de the reference for the therapy of aortic disease disease.Methods:1.Select thirty subjects as normal control(group A),and no one suffer angina;twenty-two patients who are in hospital from october 2003 to march 2008 of simply moderate to severe aortic valve insufficiency as groupB,of which seven subjects suffer angina and ischemic of electrocardiogram;twenty-six patients of simply moderate to severe aortic stenosis as group C,of which sixteen subjects suffer angina and ischemic of electrocardiogram;sixteen patients of simply moderate to severe aortic stenosis and aortic valve insufficiency as group D,of which twelve subjects suffer angina and ischemic of electrocardiogram.To select twenty-five patients of moderate to severe aortic valve insufficiency as group E,of which three ones are diagnosed coronary heart disease after coronary angiography;thirty patients of moderate to severe aortic stenosis as group F,of which three ones are diagnosed coronary heart disease after coronary angiography;seventeen patients of moderate to severe aortic stenosis and aortic valve insufficiency as group F,of which one is diagnosed coronary heart disease after coronary angiography.2.All subjects experience the routine electrocardiogram,Doppler echocardiography and coronary angiography.To describe the result of coronary angiography through TIMI frame count method.3.Record the characteristics of all subjects,left ventricular ejection,left ventricu- lar mass index et al and TIMI frame count.Results:1.In Aortic valve insufficiency(group B),systolic blood pressure,pulse pressure,the index of left ventricular mass(LVMI),LAD(corrected),Cx,and RCA TIMI frame counts(TFC) were all higher than the normal control(group A)[15.51± 1.41frame vs12.67±1.68frame(P<0.01),22.24±1.58frame vs19.23±2.54frame(P <0.01),21.10±1.80vs17.89±2.18frame(P<0.01)],Diastolic blood pressure,ejection fract- ion(EF) was lower than group A;in Aortic stenosis(group C),the index of left ventricular mass(LVMI),LAD(corrected),Cx,and RCA TIMI frame counts(TFC) were all higher than group A[16.71±1.71frame vs 12.67±1.68frame(P<0.01), 24.19±3.99frame vs 19.23±2.54frame(P< 0.05),22.83±2.42frame vs17.89±2.18 frame(P<0.01)],ejection fraction(EF) was lower than group A;in Aortic valve insufficiency and Aortic stenosis(group D),systolic blood pressure,the index of left ventricular mass(LVMI),pulse pressure,LAD(corrected),Cx,and RCA TIMI frame counts(TFC) were all higher than group A[18.33±2.28frame vs 12.67±1.68frame (P<0.01),27.06±1.67frame vs19.23±2.54frame(P<0.01),24.63±1.52frame vs 17.89±2.18frame(P<0.01)],ejection fraction(EF) was lower than group A.In aortic valve disease(B+C+D),LAD(corrected),Cx,and RCA TIMI frame counts(TFC) were all higher than group A(P<0.01).The difference of LAD(corrected),Cx,and RCA TIMI frame counts has statistical significance between group B,group C and group D(P<0.01)2.The incidence of angina has statistical significance between aortic stenosis(group E ),Aortic valve insufficiency(group F),aortic stenosis and aortic valve insufficiency( group G)(P < 0.05),but the incidence of coronary heart disease has no statistical significance between them(P > 0.05).Conclusion:1.The coronary artery blood flow velocity of aortic valve disease is slow. The slowly coronary artery blood flow velocity is one of the index of myocardial ischemia,which is one of the reasons why these patients suffer angina.2.The routine coronary angiography is necessary for the patient of aortic valve disease who will undergo the aortic valve replacement.