P6220The non-invasive coronary flow reserve predicts exercise capacity in patients undergoing cardiac rehabilitation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Meimoun ◽  
M Ghannem ◽  
J Clerc
Keyword(s):  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Systolic Function ◽  
Left Ventricular ◽  
Maximal Heart Rate ◽  
Transthoracic Doppler Echocardiography ◽  
Non Invasive ◽  
Flow Reserve

Abstract Background The benefit of exercise on peripheral muscles is established but the exact role of the coronary microcirculation in exercise capacity after cardiac rehabilitation (CR) is unclear. Objective: Our aim was to test the relationship between non-invasive coronary flow reserve (CFR) and exercise capacity in patients undergoing CR after acute myocardial infarction (AMI). Methods CFR was performed by transthoracic Doppler echocardiography in the left anterior descending artery 24 h after angioplasty (CFR1) and after 20 sessions of CR program (at 4±1 months) (CFR2) in 60 consecutive patients (57±11 years, 30% women) with an anterior AMI successfully treated by primary coronary angioplasty. CFR was performed in a modified parasternal view using intravenous adenosine infusion (0.14 mg/kg/min within 2 minutes). CR program consisted of a half hour of fractioned exercise added of a half hour session of general gymnastics and body building. To test the exercise capacity, symptom limited exercise echocardiography was performed just after the CFR2, in a semi-supine position, starting at 25 watts, with 20–25 watts increments of workload every two minutes. Results CFR was measured successfully in all patients, and CFR2 was significantly higher than CFR1 (2.9±0.65 vs 1.9±0.4, p<0.001). Though CFR1 was correlated to left ventricular systolic function and its improvement at follow-up (all, p<0.01), CFR2 was independently related to exercise capacity (mean workload 100±30 watts, percent maximal heart rate 83±12%, no ischemia, no new wall motion abnormalities in all tests) after adjusting for age, sex, and body mass index (r=0.6, p<0.01). Conclusion CFR predicts exercise capacity in patients undergoing a CR program after AMI. The improvement of CFR contributes to cardiac performance.

scholarly journals Coronary flow reserve as a link between diastolic and systolic function and exercise capacity in heart failure

2012 ◽  
Vol 14 (7) ◽  
pp. 677-683 ◽  
Author(s):  
M. Snoer ◽  
T. Monk-Hansen ◽  
R. H. Olsen ◽  
L. R. Pedersen ◽  
O. W. Nielsen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Exercise Capacity ◽  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Systolic Function ◽  
Flow Reserve

Abstract 3339: Effects of Atorvastatin 10 mg versus 40 mg in Eight Months Follow-up Coronary Flow Reserve and Clinical Events in Patients with Acute Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Soon Jun Hong ◽  
Seung Cheol Choi ◽  
Jong Il Choi ◽  
Hyung Joon Joo ◽  
Seung Yong Shin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Systolic Function ◽  
Left Ventricular ◽  
Clinical Events ◽  
Flow Reserve ◽  
Cd34 Cells

Background: Circulating bone marrow-derived stem cells are capable of homing to sites of myocardial infarction and endothelial disruption, thereby restoring myocardial function and microvascular integrity after acute myocardial infarction. We compared the effects of atorvastatin 10 mg versus 40 mg in follow-up clinical events and in restoring coronary flow reserve (CFR) during the 8 months follow-up in patients with acute myocardial infarction. Methods: CFR, which is reflective of the integrity of coronary microvasculature, was measured by using intracoronary Doppler wire in 102 consecutive patients with acute myocardial infarction 5 days after the successful primary coronary intervention with sirolimus-eluting stents. Stented patients were randomly assigned to either atorvastatin 10 mg (ATOR10, n=52) or atorvastatin 40 mg (ATOR40, n=50). All patients received aspirin and clopidogrel. Clinical events such as death, myocardial infarction, and target lesion revascularization (TLR) were compared during the 8-month follow-up. Results: CFR increased significantly in both groups during the 8 months follow-up (1.9 ± 0.6 at baseline vs. 2.6 ± 0.7 at follow-up in the ATOR10, p<0.05; 1.9 ± 0.7 at baseline vs. 2.9 ± 0.8 at follow-up in the ATOR40, p<0.05). The changes from baseline in CFR was greater in the ATOR40 Group compared with the ATOR10 Group (1.0 ± 0.8 vs. 0.7 ± 0.6, p<0.05, respectively). The numbers of CD34+ and CXCR4+ cells were significantly greater in the ATOR40 Group compared with the ATOR10 Group (13 ± 10 vs. 6 ± 6, p<0.05, respectively for CD34 cells and 15 ± 14 vs. 10 ± 9, p<0.05, respectively for CXCR4+ cells per 1uL). Clinical events such as death (0 patient in the ATOR10 vs. 2 patients in the ATOR40, p=0.247), myocardial infarction (2 patients in the ATOR10 vs. 1 patient in the ATOR40, p=0.557), and TLR (2 patients in the ATOR10 vs. 2 patients in the ATOR40, p=0.692) demonstrated no significant differences during the follow-up. Conclusion: The increases from baseline in CFR, CD34+ cells and CXCR4+ cells were significantly greater in the ATOR40 Group compared with the ATOR10 Group. However, the improvement in left ventricular systolic function and the rate of clinical events revealed no significant differences between the 2 groups.

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