Coronary microvascular dysfunction in patients undergoing transcatheter aortic valve implantation: A systematic review and meta-analysis.

What was studied

This review looked at problems in the tiny blood vessels of the heart. These problems are called CMD. The focus was adults with severe aortic stenosis who had TAVI. The team searched several databases for work from 2010 to 2025. They pooled data from the studies they found. Studies checked CMD with wire tests, vessel images, Doppler tests or heart scans.

What they found

Data from 10 studies with 1,212 people showed how common CMD was. The abstract gives separate figures for wire tests and image-based tests. A measure of blood flow reserve, called CFR, rose by 0.49 after TAVI. Some measures of vessel resistance fell, but one key measure did not change. 2 studies with 585 people looked at CMD and later heart events. The results did not show a clear link.

What it means for patients

The authors say the test used changes how often CMD is found. They say CFR tends to get better after TAVI. They think this is likely because the heart needs less blood at rest. They do not think it comes from repair of the vessels. They see the link between CMD and heart events as an idea to test further.

Why it is not certain yet

Only 2 studies looked at CMD and later heart events. The studies used different ways to define CMD. This made results differ a lot from study to study. The ways each study worked out risk could not be fully compared. The authors say new studies at many centers with one CMD definition are needed. A review can only be as good as the studies in it.

Source

Coronary microvascular dysfunction in patients undergoing transcatheter aortic valve implantation: A systematic review and meta-analysis.

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