Diastolic-systolic velocity ratio to detect coronary stenoses under physiological resting conditions: a mechanistic study

Autor: Jan J Piek, Javier Escaned, Guus A de Waard, Christopher J Broyd, Christopher M Cook, Nina W van der Hoeven, Ricardo Petraco, Sukhjinder S Nijjer, Tim P van de Hoef, Mauro Echavarria-Pinto, Martijn Meuwissen, Sayan Sen, Paul Knaapen, Niels van Royen, Justin E Davies
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Open Heart, Vol 6, Iss 1 (2019)
Druh dokumentu: article
ISSN: 2053-3624
DOI: 10.1136/openhrt-2018-000968
Popis: Objective Diastolic-systolic velocity ratio (DSVR) is a resting index to assess stenoses in the left anterior descending artery (LAD). DSVR can be measured by echocardiographic or intracoronary Doppler flow velocity. The objective of this cohort study was to elucidate the fundamental rationale underlying the decreased DSVR in coronary stenoses.Methods In cohort 1, simultaneous measurements of intracoronary Doppler flow velocity and pressure were acquired in the LAD of 228 stable patients. Phasic stenosis resistance, microvascular resistance and total vascular resistance (defined as stenosis and microvascular resistance combined) were studied during physiological resting conditions. Stenoses were classified according to severity by strata of 0.10 fractional flow reserve (FFR) units.Results DSVR was decreased in stenoses with lower FFR. Stenosis resistance was equal in systole and diastole for every FFR stratum. Microvascular resistance was consistently higher during systole than diastole. In lower FFR strata, stenosis resistance as a percentage of the total vascular resistance increases both during systole and diastole. The difference between the stenosis resistance as a percentage of total vascular resistance during systole and diastole increases for lower FFR strata, with an accompanying rise in diastolic-systolic resistance ratio. A significant inverse correlation was observed between DSVR and the diastolic-systolic resistance ratio (r=0.91, p
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