Coronary Flow Velocity Reserve in the Three Main Coronary Arteries Assessed with Transthoracic Doppler: A Comparative Study with Quantitative Coronary Angiography

Vegsundvåg, Johnny; Holte, Espen; Wiseth, Rune; Hegbom, Knut; Hole, Torstein

doi:10.1016/j.echo.2011.03.010

Cited by 49 publications

(35 citation statements)

References 37 publications

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“…The coronary endothelial and microvascular dysfunction affects the left ventricle globally, with the left anterior descending artery (LAD) being the most important coronary vessel determining the left ventricle function 14. Also, the feasibility of CFR measurements in the LAD is superior to other coronary arteries 6. Thus, we evaluated CFR only in the mid to distal LAD by TTE using a Vivid E9 XDclear (GE Vingmed Ultrasound, Horten, Norway) ultrasound system connected to an M5Sc-D transthoracic transducer, using spectral Doppler signals with the use of intravenous adenosine (0.14 mg/kg/min, within 2 min) to induce hyperaemia 6.…”

Section: Methodsmentioning

confidence: 99%

Effect of interleukin-6 inhibition on coronary microvascular and endothelial function in myocardial infarction

Holte

Kleveland²,

Ueland

et al. 2017

Heart

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Section: Methodsmentioning

confidence: 99%

Effect of interleukin-6 inhibition on coronary microvascular and endothelial function in myocardial infarction

Holte

Kleveland²,

Ueland

et al. 2017

Heart

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“…The cutoff value of <2 of CFR is precise for detecting significant (> 75%) LAD stenosis with a sensitivity of 86% and a specificity of 70% [14]. The same CFR criteria can also be applied to right coronary artery and left circumflex artery [14].…”

Section: Clinical Applications Of Tde Cfr Angiographically Obstructivmentioning

confidence: 96%

“…The same CFR criteria can also be applied to right coronary artery and left circumflex artery [14]. The CFR <1, which suggests coronary steal, may be a predictor of critical stenosis (>90%) [17].…”

Section: Clinical Applications Of Tde Cfr Angiographically Obstructivmentioning

confidence: 98%

Clinical Applications of Transthoracic Doppler Echocardiographic Coronary Flow Reserve Measurements in the Left Anterior Descending Coronary Artery

Hung

Cherng

2011

Journal of Medical Ultrasound

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KEY WORDScoronary flow reserve, left anterior descending coronary artery, Transthoracic Doppler echocardiography Transthoracic Doppler echocardiography (TDE) is a noninvasive tool for measuring coronary flow reserve in the epicardial coronary arteries. In the absence of stenosis in the epicardial coronary artery, TDE can detect impaired microvascular vasodilatation associated with diseases, including reperfused myocardial infarct, systemic arterial hypertension, diabetes mellitus, coronary vasospasm, microvascular angina, and hypertrophic cardiomyopathy by demonstrating a decrease in the coronary flow reserve. Because it is noninvasive, TDE allows for serial coronary flow reserve evaluations to explore the effect of various therapies. This noninvasive imaging technique expands the field of diagnostic echocardiography and brings new insight into the pathophysiology of ischemic heart disease. This review outlines rationale of TDE to evaluate coronary flow reserve in the left anterior descending coronary artery and discusses its clinical applications. ª

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“…As a case in point, the cut-off value of <2 of CFR is precise for detecting significant (>75%) LAD stenosis with a sensitivity of 86% and a specificity of 70%. 46 Furthermore, CFR < 2 had 91% sensitivity, 95% specificity, and 96% positive and 97% negative predictive values to detect significant stenosis in patients with LAD stents. 47 Therefore, dysfunction of microvascular coronary flow represented through CFR impairment could be a substrate responsible for the occurrence of angina pectoris symptoms and potentially fatal arrhythmias registered in AS patients with normal epicardial coronary arteries.…”

Section: Clinical Implication Of Coronary Microvascular Dysfunction Imentioning

confidence: 99%

Diabetes mellitus and coronary microvascular function in asymptomatic patients with severe aortic stenosis and nonobstructed coronary arteries

Banović

Brković

Nedeljkovic

et al. 2016

Diabetes and Vascular Disease Research

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Background and aim: Coronary flow reserve is impaired in asymptomatic patients with aortic stenosis and has a prognostic value. We investigated whether the type II diabetes mellitus additionally impairs microvascular circulation assessed by coronary flow reserve in patients with asymptomatic severe aortic stenosis, normal left ventricular ejection fraction and nonobstructed coronary arteries. Methods: A total of 128 patients, mean age of 66.35 ± 10.51 (58.6% males), with severe aortic stenosis and normal left ventricular ejection fraction were enrolled in this study. Patients with diabetes mellitus, those who were treated for diabetes mellitus or had documentation confirming the diagnosis of diabetes mellitus, were considered. All patients underwent coronary angiography and had no obstructive coronary disease (defined as having no stenosis >50% in diameter), standard transthoracic Doppler-echocardiographic study and adenosine stress transthoracic echocardiography for coronary flow reserve measurement. Results: Diabetes mellitus was present in 26 patients (20.31%). There was no significant difference in aortic stenosis severity between diabetic and non-diabetic patients [aortic valve area (0.81 ± 0.18 vs 0.85 ± 0.15 cm 2 ) and V max (4.20 ± 0.57 vs 4.21 ± 0.48 m/s)]. Mean coronary flow reserve in diabetic patients was 1.98 ± 0.48, while mean coronary flow reserve in non-diabetic patients was 2.64 ± 0.54 (p < 0.01). Diabetes mellitus was independent predictor of coronary flow reserve [B = −0.636, 95% confidence interval (−0.916 to −0.368), p < 0.001]. Conclusion: Diabetes mellitus additionally impairs coronary microvascular function in asymptomatic patients with severe aortic stenosis and nonobstructed coronary arteries.

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Coronary Flow Velocity Reserve in the Three Main Coronary Arteries Assessed with Transthoracic Doppler: A Comparative Study with Quantitative Coronary Angiography

Cited by 49 publications

References 37 publications

Effect of interleukin-6 inhibition on coronary microvascular and endothelial function in myocardial infarction

Effect of interleukin-6 inhibition on coronary microvascular and endothelial function in myocardial infarction

Clinical Applications of Transthoracic Doppler Echocardiographic Coronary Flow Reserve Measurements in the Left Anterior Descending Coronary Artery

Diabetes mellitus and coronary microvascular function in asymptomatic patients with severe aortic stenosis and nonobstructed coronary arteries

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