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

Cardiovascular Ultrasound

Research

Rasmus Huan Olsen¹  Martin Snoer¹  Eva Prescott¹  Lene Rørholm Pedersen¹  Andreas Kjaer²  Thomas Emil Christensen²  Adam Ali Ghotbi²  Philip Hasbak²  Steen B. Haugaard³ 

[1] Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Building 67, Bispebjerg Bakke 23, DK-2400, Copenhagen NV, Denmark;Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark;Department of Internal Medicine and Clinical Research Centre, Amager and Hvidovre Hospitals, University of Copenhagen, Copenhagen, Denmark;

关键词: Coronary artery disease;    Coronary flow reserve;    Echocardiography;    Microvascular function;    Obesity;    Positron emission tomography;   

DOI  :  10.1186/s12947-016-0066-3

 received in 2016-02-19, accepted in 2016-06-01,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundCoronary 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.MethodsParticipants 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).ResultsEighty-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).ConclusionsCFVR 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.

【 授权许可】

CC BY   
© Oslen et al. 2016