Coronary flow velocity reserve and indices describing aortic distensibility in patients after coronary angiography

2004 ◽  
Vol 96 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Attila Nemes ◽  
Tamás Forster ◽  
Noémi Gruber ◽  
Miklós Csanády
Keyword(s):  
Coronary Angiography ◽  
Flow Velocity ◽  
Coronary Flow ◽  
Aortic Distensibility ◽  
Coronary Flow Velocity Reserve ◽  
Coronary Flow Velocity

scholarly journals Coronary Flow Velocity Reserve Using Dobutamine Test for Noninvasive Functional Assessment of Myocardial Bridging

2021 ◽  
Vol 11 (1) ◽  
pp. 204
Author(s):  
Srdjan B. Aleksandric ◽  
Ana D. Djordjevic-Dikic ◽  
Vojislav L. Giga ◽  
Milorad B. Tesic ◽  
Ivan A. Soldatovic ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Myocardial Ischemia ◽  
Flow Velocity ◽  
Coronary Flow ◽  
Exercise Stress ◽  
Functional Evaluation ◽  
Coronary Flow Velocity Reserve ◽  
Myocardial Bridging ◽  
Transthoracic Doppler Echocardiography ◽  
Coronary Flow Velocity

Background: It has been shown that coronary flow velocity reserve (CFVR) measurement by transthoracic Doppler echocardiography (TTDE) during dobutamine (DOB) provocation provides a more accurate functional evaluation of myocardial bridging (MB) compared to adenosine. However; the cut-off value of CFVR during DOB for identification of MB associated with myocardial ischemia has not been fully clarified. Purpose: This prospective study aimed to determine the cut-off value of TTDE-CFVR during DOB in patients with isolated-MB, as compared with stress-induced wall motion abnormalities (VMA) during exercise stress-echocardiography (SE) as reference. Methods: Eighty-one symptomatic patients (55 males [68%], mean age 56 ± 10 years; range: 27–74 years) with the existence of isolated-MB on the left anterior descending artery (LAD) and systolic MB-compression ≥50% diameter stenosis (DS) were eligible to participate in the study. Each patient underwent treadmill exercise-SE, invasive coronary angiography, and TTDE-CFVR measurements in the distal segment of LAD during DOB infusion (DOB: 10–40 μg/kg/min). Using quantitative coronary angiography, both minimal luminal diameter (MLD) and percent DS at MB-site at end-systole and end-diastole were determined. Results: Stress-induced myocardial ischemia with the occurrence of WMA was found in 23 patients (28%). CFVR during peak DOB was significantly lower in the SE-positive group compared with the SE-negative group (1.94 ± 0.16 vs. 2.78 ± 0.53; p < 0.001). ROC analyses identified the optimal CFVR cut-off value ≤ 2.1 obtained during high-dose dobutamine (>20 µg/kg/min) for the identification of MB associated with stress-induced WMA, with a sensitivity, specificity, positive and negative predictive value of 96%, 95%, 88%, and 98%, respectively (AUC 0.986; 95% CI: 0.967–1.000; p < 0.001). Multivariate logistic regression analysis revealed that MLD and percent DS, both at end-diastole, were the only independent predictors of ischemic CFVR values ≤2.1 (OR: 0.023; 95% CI: 0.001–0.534; p = 0.019; OR: 1.147; 95% CI: 1.042–1.263; p = 0.005; respectively). Conclusions: Noninvasive CFVR during dobutamine provocation appears to be an additional and important noninvasive tool to determine the functional severity of isolated-MB. A transthoracic CFVR cut-off ≤2.1 measured at a high-dobutamine dose may be adequate for detecting myocardial ischemia in patients with isolated-MB.

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