Early changes in CT-derived quantitative flow ratio after transcatheter aortic valve replacement: a serial coronary physiological assessment
- 1Department of Cardiology, Fujian Medical University Union Hospital, Fujian Cardiovascular Medicine Center, Fujian Institute of Coronary Artery Disease, Fujian Cardiovascular Research Center, Fujian Medical University Heart Center , ,
Abstract
Aims: Transcatheter aortic valve replacement (TAVR) is an established treatment for severe aortic valve stenosis, but its effects on coronary physiology remain incompletely understood. CT-derived quantitative flow ratio (CT-QFR) enables non-invasive assessment of coronary physiology. This study aimed to investigate the early changes in CT-QFR following TAVR.
Methods: This retrospective study included consecutive patients with severe aortic stenosis who underwent coronary computed tomography angiography before and within 7 days after TAVR. CT-QFR was calculated for all analyzable coronary vessels. Longitudinal changes in CT-QFR were evaluated using linear mixed-effects models with patient identifier as a random effect.
Results: A total of 109 patients (324 coronary vessels) were analyzed. Plaque volume, plaque burden, and minimal lumen diameter remained unchanged after TAVR, whereas transvalvular pressure gradients decreased significantly. Overall, CT-QFR increased modestly following TAVR ( β =0.018, P < 0.001). Significant increases were observed in the left anterior descending and right coronary arteries, whereas no significant change was detected in the left circumflex artery. Vessels with baseline %DS ≥50% demonstrated greater CT-QFR increases than those with less severe stenosis (interaction β =0.104, P < 0.001). Likewise, vessels with baseline CT-QFR <0.80 showed significantly larger post-TAVR increases than vessels with baseline CT-QFR ≥0.80 (interaction β =0.117, P < 0.001).
Conclusion: TAVR was associated with modest early increases in CT-QFR, particularly in vessels with greater anatomical stenosis or baseline physiological impairment. These findings suggest that coronary physiological assessment in severe aortic stenosis may be influenced by valve intervention and should be interpreted cautiously during the peri-TAVR period.
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BibTeX
@article{li2026early,
title = {{Early changes in CT-derived quantitative flow ratio after transcatheter aortic valve replacement: a serial coronary physiological assessment}},
author = {Lieyou Li and Yonghui Yu and Xinjie Zeng and Lijun Luo and Zhongwei Shi and Linyan Chen and Feng Hu and Lin Fan},
journal = {Frontiers in cardiovascular medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1902728},
url = {https://europepmc.org/article/PMC/PMC13690769},
note = {CC BY},
}
RIS
TY - JOUR
TI - Early changes in CT-derived quantitative flow ratio after transcatheter aortic valve replacement: a serial coronary physiological assessment
AU - Lieyou Li
AU - Yonghui Yu
AU - Xinjie Zeng
AU - Lijun Luo
AU - Zhongwei Shi
AU - Linyan Chen
AU - Feng Hu
AU - Lin Fan
PY - 2026
DA - 2026/10/09
JO - Frontiers in cardiovascular medicine
DO - 10.3389/fcvm.2026.1902728
UR - https://europepmc.org/article/PMC/PMC13690769
AB - Aims: Transcatheter aortic valve replacement (TAVR) is an established treatment for severe aortic valve stenosis, but its effects on coronary physiology remain incompletely understood. CT-derived quantitative flow ratio (CT-QFR) enables non-invasive assessment of coronary physiology. This study aimed to investigate the early changes in CT-QFR following TAVR. Methods: This retrospective study included consecutive patients with severe aortic stenosis who underwent coronary computed tomography angiography before and within 7 days after TAVR. CT-QFR was calculated for all analyzable coronary vessels. Longitudinal changes in CT-QFR were evaluated using linear mixed-effects models with patient identifier as a random effect. Results: A total of 109 patients (324 coronary vessels) were analyzed. Plaque volume, plaque burden, and minimal lumen diameter remained unchanged after TAVR, whereas transvalvular pressure gradients decreased significantly. Overall, CT-QFR increased modestly following TAVR ( β =0.018, P < 0.001). Significant increases were observed in the left anterior descending and right coronary arteries, whereas no significant change was detected in the left circumflex artery. Vessels with baseline %DS ≥50% demonstrated greater CT-QFR increases than those with less severe stenosis (interaction β =0.104, P < 0.001). Likewise, vessels with baseline CT-QFR <0.80 showed significantly larger post-TAVR increases than vessels with baseline CT-QFR ≥0.80 (interaction β =0.117, P < 0.001). Conclusion: TAVR was associated with modest early increases in CT-QFR, particularly in vessels with greater anatomical stenosis or baseline physiological impairment. These findings suggest that coronary physiological assessment in severe aortic stenosis may be influenced by valve intervention and should be interpreted cautiously during the peri-TAVR period.
SN - 2297-055X
ER -