Implication of the continuous prognostic spectrum of Doppler echocardiographic derived coronary flow reserve on left anterior descending artery

The American Journal of Cardiology
Lauro CortigianiRosa Sicari

Abstract

The additive prognostic value of coronary flow reserve (CFR) over regional wall motion has been established, but there is more than a binary (normal-abnormal) response in CFR, which can be continuously titrated. We assessed the prognostic value of quartiles of CFR, evaluated by transthoracic Doppler of the left anterior descending coronary artery (LAD), in patients with known or suspected coronary artery disease (CAD). One thousand six hundred twenty patients (1,006 men, 64 +/- 11 years of age) underwent dipyridamole (up to 0.84 mg/kg over 6 minutes) stress echocardiography with CFR evaluation of LAD by Doppler and coronary angiography. Patients were followed up for a median of 19 months. Mean CFR in the entire population was 2.25 +/- 0.65. Stress echocardiogram was positive for ischemia in 480 patients (30%). Obstructive (>or=70% vessel stenosis) CAD at angiography was present in 650 patients (40%). During follow-up, there were 298 events (42 deaths, 73 ST-elevation myocardial infarctions, and 183 non-ST-elevation myocardial infarctions). Patients (n = 399) undergoing revascularization were censored. With the Kaplan-Meier method, the first quartile of CFR (<or=1.80) was associated with a worse (p <0.0001) event rate than other...Continue Reading

References

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Citations

Jun 15, 2011·Annales de cardiologie et d'angéiologie·C JeannotM Giraud
Oct 15, 2014·Nature Reviews. Cardiology·Paolo G CamiciOrnella Rimoldi
Feb 26, 2015·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Xiangfei WangJunbo Ge
Dec 17, 2010·World Journal of Cardiology·Simona SitiaMaurizio Turiel
Nov 22, 2018·The International Journal of Cardiovascular Imaging·Lauro CortigianiEugenio Picano
May 8, 2018·Rheumatology International·Gian Luca ErreAngelo Zinellu
Dec 18, 2020·European Heart Journal·Rosa Sicari
Feb 19, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Masakazu YamagishiUNKNOWN Japanese Circulation Society Working Group
Jul 30, 2021·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Kamilla P BjerreHans Eiskjær

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