Coronary flow velocity reserve by echocardiography: feasibility, reproducibility and agreement with PET in overweight and obese patients with stable and revascularized coronary artery disease.

Autor: Olsen RH; Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Building 67, Bispebjerg Bakke 23, DK-2400, Copenhagen NV, Denmark. rasmus.huan.olsen@regionh.dk., Pedersen LR; Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Building 67, Bispebjerg Bakke 23, DK-2400, Copenhagen NV, Denmark., Snoer M; Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Building 67, Bispebjerg Bakke 23, DK-2400, Copenhagen NV, Denmark., Christensen TE; Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Ghotbi AA; Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Hasbak P; Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Kjaer A; Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Haugaard SB; Department of Internal Medicine and Clinical Research Centre, Amager and Hvidovre Hospitals, University of Copenhagen, Copenhagen, Denmark., Prescott E; Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Building 67, Bispebjerg Bakke 23, DK-2400, Copenhagen NV, Denmark.
Jazyk: angličtina
Zdroj: Cardiovascular ultrasound [Cardiovasc Ultrasound] 2016 Jun 07; Vol. 14 (1), pp. 22. Date of Electronic Publication: 2016 Jun 07.
DOI: 10.1186/s12947-016-0066-3
Abstrakt: Background: Coronary flow velocity reserve (CFVR) measured by transthoracic Doppler echocardiography of the LAD is used to assess microvascular function but validation studies in clinical settings are lacking. We aimed to assess feasibility, reproducibility and agreement with myocardial flow reserve (MFR) measured by PET in overweight and obese patients.
Methods: Participants with revascularized coronary artery disease were examined by CFVR. Subgroups were examined by repeated CFVR (reproducibility) or Rubidium-82-PET (agreement). To account for time variation, results were computed for scans performed within a week (1-week) and for all scans regardless of time gap (total) and to account for scar tissue for patients with and without previous myocardial infarction (MI).
Results: Eighty-six patients with median BMI 30.9 (IQR 29.4-32.9) kg × m(-2) and CFVR 2.29 (1.90-2.63) were included. CFVR was feasible in 83 (97 %) using a contrast agent in 14 %. For reproducibility overall (n = 21) limits of agreement (LOA) were (-0.75;0.71), within-subjects coefficient of variation (CV) 11 %, and reliability 0.84. For reproducibility within 1-week (n = 13) LOA were (-0.33;0.25), within-subjects CV 5 %, and reliability 0.97. Agreement with MFR of the LAD territory (n = 35) was without significant bias and overall LOA were (-1.40;1.46). Agreement was best for examinations performed within 1-week of participants without MI of the LAD-territory (n = 12); LOA = (-0.68;0.88).
Conclusions: CFVR was highly feasible with a good reproducibility on par with other contemporary measures applied in cardiology. Agreement with MFR was acceptable, though discrepancy related to prior MI has to be considered. CFVR of LAD is a valid tool in overweight and obese patients.
Databáze: MEDLINE
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