The TAVI And Coronary Physiology groups, of which Dr Malik is a key member, have another publication out, with our young colleague Dr Ahmed winning award nominations!
Dr Malik says:
Assessing a narrowing in a coronary artery is not easy: symptoms do not seem to link to angiographic narrowing, but appear better linked to assessments of physiology. FFR using a wire in the coronary is being superceded by iFR, which was invented at Imperial College. When you have Aortic Valve Stenosis, there is little data to guide what happens to this physiological assessments; can we use the same criteria in assessing cut-off values?
This study suggests that iFR remains unchanged even if the aortic stenosis is removed with TAVI ( Transcatheter Aortic Valve Intervention) whilst FFR changes- thus a negative FFR might be falsely reassuring in patients with Aortic Stenosis.
Of course more patients need to be studied, but this study was challenging to do, and the results are very suggestive that IFR can be used in coronary physiology assessment even in patients with severe Aortic Stenosis.
