Impact of Coronary Artery Disease on Systolic Function in Severe Aortic Stenosis – a Multimodality Imaging Study

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ID: 314249
2026
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Abstract
Abstract Aims The aim of this study was to determine the impact of obstructive coronary artery disease (CAD) and diffuse atherosclerosis on left ventricular systolic function, measured as global longitudinal strain (GLS) by cardiac magnetic resonance (CMR) feature tracking, in patients with severe aortic stenosis (AS). Methods and results In this single-center prospective cohort study, patients with severe AS and transcatheter aortic valve implantation (TAVI) between October 2018 and February 2022 were referred for transthoracic echocardiography, cardiac MR, and TAVI computed tomography (CT). Invasive coronary angiography (ICA) was performed prior to TAVI. 94 patients (80 ± 7 years) were included. The prevalence of obstructive CAD was 20 (21%) patients. The mean GLS in patients with severe AS was -24.0 ± 6.1% and the median coronary calcium score (CCS) was 802 (IQR 302–2130). GLS was not reduced in patients with obstructive CAD compared to other patients (23.7 ± 5.9% vs 24.1 ± 6.2%, p = 0.83). A high coronary calcium score was not associated with GLS. Indexed left ventricular mass was independently related to GLS. Patients with an ischemic scar on CMR had lower GLS (20.3 ± 5.1% vs. 24.6 ± 6.1%, p = 0.02). Conclusions GLS correlated with left ventricular mass and the presence of ischemic scar, suggesting that intrinsic myocardial disease, rather than concomitant CAD alone, accounts for reduced GLS in this population.
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Authors R Halva, Satu Vaara, Suvi Syväranta, Miia Holmström, Johanna Federico, Touko Kaasalainen, Juha Peltonen, Satu Suihko, Jyri Lommi, Heikki Niemi, Valtteri Uusitalo
Journal European Heart Journal - Imaging Methods and Practice
Year 2026
DOI
10.1093/ehjimp/qyag095
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