scholarly journals 1174 Coronary flow velocity assessment in routine echocardiography predicts adverse outcomes in three-year period in different subgroups

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Zagatina ◽  
N Zhuravskaya ◽  
O Guseva ◽  
E Kalinina ◽  
Y Drozdova ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Flow Velocity ◽  
Coronary Arteries ◽  
Coronary Flow ◽  
Prognostic Value ◽  
Area Under Curve ◽  
Valve Disease ◽  
Left Main ◽  
Coronary Flow Velocity ◽  
Coronary Syndrome

Abstract Background The previous diagnostic study had demonstrated high correlation of maximal coronary flow velocity with significant stenoses by invasive methods. There is a lack of information about the prognostic value of local high velocity in coronary arteries during echocardiography. The present study was aimed at investigating the three-year prognostic value of coronary flow assessment in all patients were referred for routine echocardiography examination in different subgroup. Methods The prospective study comprises 747 consecutive patients (380 males; age 58 + 13 years) referred to echocardiography. Routine echocardiography was added with coronary flow velocity assessment in the left main (LM), left anterior descending (LAD) or circumflex (Cx) coronary arteries measured by Doppler method. Death, nonfatal myocardial infarction (MI), acute coronary syndrome (ACS) and/or revascularization were defined as major adverse cardiac events (MACE). Results During a median follow-up of 36 months, 192 patients experienced 224 MACE. Twenty-six deaths, 16 non-fatal MI, 2 ACS, 180 revascularizations were observed. The value of 67 cm/s maximal coronary flow velocity in the left main/proximal LAD/proximal LCX arteries was the best predictor for death (area under curve 0.79, 95% CI 0.76-0.82), p < 0.0001, and 66 cm/s was the best predictor for death/MI (area under curve 0.81, 95% CI 0.78-0.84), p < 0.0001. A value of 64 cm/s in left main/proximal LAD/proximal LCX arteries was a significant predictor of all MACE (area under curve 0.83, 95% CI 0.79-0.85), sensitivity 73%, specificity 84%, p < 0.0001. Death/MI/ACS syndrome were observed in the main group in 17% vs. 1% patients with coronary velocity more than 65 cm/s the left main/proximal LAD/proximal LCX arteries vs. patients with less than 65 cm/s, respectively, p < 0.0001. Arterial hypertension subgroup. Deaths occurred in 9% vs. 1%, p < 0.003. Death/MI/ACS were observed in 11% vs. 1%, p < 0.004. Subgroup with known CAD. Deaths occurred in 11% vs. 3%, p < 0.04. Death/MI/ACS were observed in 20% vs. 3%, p < 0.0006. Subgroup of patient with unknown origin chest pain. Deaths occurred in 3% vs. 1%, p – non significant. Death/MI/ACS observed in 9% vs. 0, p < 0.04. Subgroup with valve disease. Deaths occurred in 17% vs. 0%, p < 0.02. Death/MI/ACS were observed in 17% vs. 0%, p < 0.02. Conclusion The coronary velocity parameters give long-term prognostic information that can be used to identify persons with a high risk of MACE in non-selected patients, also as in patients with arterial hypertension, known or suspected CAD, valve disease. Abstract 1174 Figure.

scholarly journals Prognostic value of non-invasive coronary artery flow velocity assessment in elderly patients

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E Kalinina ◽  
A Zagatina ◽  
N Zhuravskaya ◽  
D Shmatov
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Elderly Patients ◽  
Flow Velocity ◽  
Coronary Arteries ◽  
Coronary Flow ◽  
Prognostic Value ◽  
Area Under Curve ◽  
Left Coronary Artery ◽  
Maximal Velocity

Abstract Funding Acknowledgements Type of funding sources: None. Background There is a high prevalence of coronary artery disease (CAD) in the elderly population. However, symptoms of CAD are often non-specific. Dyspnoe, non-anginal pains are among the main symptoms in older patients. Exercise tests are of limited feasibility in these patients, due to neuro-muscular weakness, physical deconditioning, and orthopaedic limitations. Pharmacological tests often are contraindicated in a substantial percentage of elderly patients. Some recent studies indicate using local flow acceleration during routine echocardiography has prognostic potential for coronary artery assessments without stress testing. The aim of the study was to define the prognostic value of coronary artery ultrasound assessment in patients ≥75 years old. Methods This is a prospective cohort study. Patients ≥ 75 years old who underwent routine echocardiography with additional scans for coronary arteries over a period of 24 months were included in the study. The study group consisted of 80 patients aged 75-90 years (56 women; mean age 79 ± 4). Initial exams were performed for other reasons, primarily for arterial hypertension. Fifteen patients had known CAD. Death, non-fatal myocardial infarction (MI), and revascularization were defined as major adverse cardiac events (MACE). All patients were followed up with at a median of 32 months. Results There were 34 patients with high local velocities in the left coronary artery. Eight deaths, two non-fatal myocardial infarctions occurred, and 13 revascularizations were performed. With a ROC analysis, a coronary flow velocity >110 cm/s was the best predictor for risk of death (area under curve 0.84 [95% CI 0.74–0.92]; sensitivity 75%; specificity 88%). Only the maximal velocity in proximal left-sided coronary arteries was independently associated with death (HR 1.03, 95% CI 1.01; 1.05; p < 0.002), or death/MI (HR 1.03, 95% CI 1.01; 1.04; p < 0.0001). The cut-off value of 66 cm/s was a predictor of all MACE (area under curve 0.87 [95% CI 0.77–0.94]; sensitivity 80%; specificity 86%). Any causes of death or MI occurred more frequently in patients with velocities of >66 cm/s (27% vs. 2%; p < 0.002). The rates of MACE were 58.0% vs. 2%; p < 0.0000001, respectively. Conclusion The analysis of coronary flow in the left coronary artery during echocardiography can be used as a predictor of outcomes in elderly patients. Maximal velocities in proximal left-sided coronary arteries is independently associated with further death or myocardial infarction.

Intraoperative transesophageal assessment of coronary artery flow can predict 5 type myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Zagatina ◽  
M Novikov ◽  
N Zhuravskaya ◽  
V Balakhonov ◽  
S Efremov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Surgery ◽  
Coronary Artery ◽  
Flow Velocity ◽  
Coronary Flow ◽  
Index Number ◽  
Left Main ◽  
Coronary Flow Velocity ◽  
Before And After ◽  
Flow Velocities

Abstract Background Stenosis of a coronary artery results in an increase in flow velocity in the pathologic segment. Effective grafting should decrease the stenotic native coronary velocity according to hemodynamic law. The range of decreased velocity before and after cardiac surgery can hypothetically reflect the effectiveness of a graft. The aim of the study is to determine if measuring coronary flow velocity changes during coronary artery bypass grafting (CABG) can predict intraoperative myocardial infarction. Methods One hundred sixty-six (166) consecutive patients (121 men, 64±9 years old) referred for cardiac surgery, were prospectively included in the study. A standard basic perioperative transesophageal echocardiography (TEE) examination was performed with additional scans of the left main, left anterior descending (LAD), and circumflex (LCx) arteries' proximal segments. Measurements of coronary flow velocities were performed before and after grafting in the same sites of the arteries. The maximal value of cardiac troponin I (cTnI) after CABG and the additive criteria were accounted for in the analysis as it is described in the expert consensus document for Type 5 myocardial infarction (MI) definition. Results One hundred sixty-three patients (98%) had arterial hypertension, 28 patients (17%) had diabetes mellitus, 35 patients (21%) were currently smokers. The feasibility of coronary flow assessment during cardiac operations was 95%. Before grafting, the mean velocity in the left main artery was 91±49 cm/s, in LAD 101±35 cm/s, and in LCx 117±49 cm/s. There was a significant correlation between changes in coronary flow velocities during operation and the value of cTnI (R=0.34, p<0.0001). Ten patients met the criteria for Type 5 MI. There were no differences in age, body mass index, number of coronary arteries with stenoses, frequency of prior MI, ejection fraction or coronary flow velocity before surgery in patients with and without Type 5 MI. The group of patients with Type 5 MI had an increase in native artery velocities during surgery in comparison with patients without MI, who had a significant decrease in coronary flow velocity after grafting (30±48 vs. −10±30 cm/s; p<0.0006). Increases in native coronary velocities greater than 3 cm/s predicted Type 5 MI with 81% accuracy (sensitivity 88%, specificity 70%). Conclusion Coronary flow velocity assessment during cardiac surgery could predict an elevation of cardiac troponins and Type 5 MI. Funding Acknowledgement Type of funding source: None

Impact on Diabetes Mellitus on the Epicardial Coronary Flow Velocity Assessed by the Thrombolysis in Myocardial Infarction Frame Count

Angiology ◽  
2008 ◽  
Vol 60 (4) ◽  
pp. 431-440 ◽  
Author(s):  
Ahmet Soylu ◽  
Kurtulus Ozdemir ◽  
Mehmet Akif Duzenli ◽  
Mehmet Yazici ◽  
Mehmet Tokac
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Flow Velocity ◽  
Coronary Arteries ◽  
Coronary Flow ◽  
Coronary Flow Velocity ◽  
And Gender

The aim of this study is to evaluate the effect of type 2 diabetes mellitus on epicardial coronary flow velocity assessed by the thrombolysis in myocardial infarction frame count. The thrombolysis in myocardial infarction frame count was measured in 272 coronary arteries from 101 patients with type 2 diabetes mellitus and in 271 coronary arteries from 104 age- and gender-matched patients without type 2 diabetes mellitus referred for coronary angiography. The thrombolysis in myocardial infarction frame count was measured only in normal arteries or in arteries without significant lesion. By both univariate and multivariate analysis, the thrombolysis in myocardial infarction frame count was not related with either type 2 diabetes mellitus or the duration and glycated hemoglobin levels in the patients with type 2 diabetes mellitus. The thrombolysis in myocardial infarction frame count was significantly associated with body surface area, heart rate, and proximal coronary artery diameter. Type 2 diabetes mellitus did not affect epicardial coronary flow velocity assessed by the thrombolysis in myocardial infarction frame count.

scholarly journals P1564 Changes in coronary flow velocity measuring during coronary bypass grafting can predict elevation of cardiac troponin

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Zagatina ◽  
M Novikov ◽  
N Zhuravskaya ◽  
V Balakhonov ◽  
D Shmatov
Keyword(s):  
Coronary Artery ◽  
Flow Velocity ◽  
Cardiac Troponin ◽  
Coronary Flow ◽  
Bypass Grafting ◽  
Left Main ◽  
Coronary Flow Velocity ◽  
Before And After ◽  
Velocity Changes ◽  
75Th Quartile

Abstract Background Stenosis of a coronary artery results in an increase in flow velocity in the pathologic segment. Effective grafting should decrease the stenotic native coronary velocity according to a hemodynamic law. The range of decreased velocity can hypothetically reflect the effectiveness of a graft. Grafting effect insufficiencies often cause elevations in periprocedural cardiac troponin (cTn) elevation. The aim of the study is to determine, if measuring coronary flow velocity changes during coronary artery bypass grafting (CABG) can predict further cTn elevation. Methods and results Consecutive 68 patients (48 men, 64 ± 9 years old), who were referred for CABG, were included into the study. A standard basic perioperative transesophageal echocardiography (TEE) examination was performed with additional scans of the left main, left anterior descending (LAD), and circumflex (LCx) arteries’ proximal segments. Measurements of coronary flow velocities was performed before and after grafting in the same sites of the arteries. The maximal value of cTnI within 48 hours after CABG was accounted for in the analysis. All patients had arterial hypertension, 15 patients (22%) had diabetes mellitus, 12 patients (18%) was current smokers. Forty-one patients (60%) had prior myocardial infarctions, 18 persons (26%) had previous coronary stenting. The ejection fraction before the operation was 56 ± 13%. Before grafting the mean velocity in the left main artery was 79 cm/s (25th-75th quartile, 42-111), in LAD 98 cm/s (25th-75th quartile, 71-125), and in LCx 116 cm/s (25th-75th quartile, 68-156). There was a strong significant correlation between changes in coronary flow velocities and the value of cTnI (R = 0.56, p < 0.0004). The patients with and without significant elevations in cTnI had differences in coronary velocity changes before and after grafting (p < 0.009). Patients with elevated cTnI in more than 5 times, had, on average, an increase in the velocities for native arteries of 21 ± 19 cm/s. Conclusion Coronary flow velocity assessment during CABG could predict an elevation of cardiac troponins after cardiac surgery. Abstract P1564 Figure.

scholarly journals Prognostic value of calcium score and coronary flow velocity reserve in asymptomatic diabetic patients

2015 ◽  
Vol 13 (1) ◽  
Author(s):  
Miodrag Dikic ◽  
Milorad Tesic ◽  
Zeljko Markovic ◽  
Vojislav Giga ◽  
Ana Djordjevic-Dikic ◽  
...  
Keyword(s):  
Flow Velocity ◽  
Coronary Flow ◽  
Prognostic Value ◽  
Calcium Score ◽  
Diabetic Patients ◽  
Coronary Flow Velocity Reserve ◽  
Coronary Flow Velocity
Sign in / Sign up

Export Citation Format

Share Document