Simultaneous assessment of wall motion and coronary flow velocity in the left anterior descending coronary artery during dipyridamole stress echocardiography

Coronary Flow Velocity Reserve during Pharmacologic Stress Echocardiography with Normal Contractility Adds Important Prognostic Value in Diabetic and Nondiabetic Patients

“…The simultaneous recording of wall motion and coronary flow velocity reserve (CFVR) images is today the state of the art for drug-induced stress studies in some laboratories. [6][7][8][9][10][11] It is established that left anterior descending coronary artery (LAD) CFVR < 2 with dobutamine or dipyridamole increases the diagnostic sensitivity of stress echocardiography, [11][12][13][14] and recent evidence has shown that dipyridamole can also provide additional prognostic information to contractile analysis in patients with known or suspected CAD. [15][16][17][18][19] In this observational study, we investigated the mid-and longterm prognostic information derived from the transthoracic Doppler echocardiographic analysis of CFVR and its degree of LAD restriction in patients with and those without diabetes with known or suspected CAD who underwent stress echocardiography with normal wall motion performed with dobutamine or dipyridamole.…”

Transthoracic Echocardiography in the Assessment of Coronary Arteries

“…The inverse correlation between CFVR and peak wall motion score index in the overall study population was significant (r=0.46: p<0.001), and the concordance between the 2 techniques was good (80%) (Rigo et al, 2003). CFVR had excellent sensitivity (81-94%) but moderate or good specificity (65-84%) in detecting significant LAD stenosis whereas wall motion score index showed lower sensitivity (69-74%) and higher specificity (82-95%), and both techniques demonstrated a similar diagnostic accuracy ranging from 82 to 86% for CFVR and from 81 to 84% for wall motion score index (Rigo et al, 2003;Lowenstein et al, 2003;Nohtomi et al, 2003). So, the data for flow and function may be complementary in predicting the underlying angiographic findings and increase the diagnostic accuracy up to 94% (Nohtomi et al, 2003), because abnormal wall motion may confirm and negative CFVR may exclude CAD more accurately.…”

Assessment of Coronary Flow During Stress Testing: Does it Add Diagnostic and Prognostic Value?

“…In a meta-analysis on CFR and wall motion, a head-tohead comparison during DIPSE published by Rigo et al (Table 2), they identified five articles (from Italy, Argentina, and Japan) and found an increase in diagnostic accuracy of 79±5 to 89±7 [4•, 7••, [10][11][12][13]. It becomes clear that by adding the CFR-LAD evaluation to wall motion analysis, there is an increase in the sensitivity of the test, while maintaining a very good value in terms of specificity.…”

“…CFR and 2D echocardiography wall motion analysis offer complementary information, usually in a one shot study during pharmacological stress testing [4•, 7••, [10][11][12][13].…”