The Prognostic Value of Coronary Flow Velocity Reserve in Two Coronary Arteries During Vasodilator Stress Echocardiography

2019 ◽  
Vol 32 (1) ◽  
pp. 81-91 ◽  
Author(s):  
Lauro Cortigiani ◽  
Fausto Rigo ◽  
Francesco Bovenzi ◽  
Rosa Sicari ◽  
Eugenio Picano
Keyword(s):  
Flow Velocity ◽  
Coronary Arteries ◽  
Coronary Flow ◽  
Prognostic Value ◽  
Stress Echocardiography ◽  
Vasodilator Stress ◽  
Coronary Flow Velocity Reserve ◽  
Coronary Flow Velocity

P1502Age- and gender-specific prognostic cutoff values of coronary flow velocity reserve in vasodilator stress echocardiography

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Lombardo ◽  
L Cortigiani ◽  
Q Ciampi ◽  
F Rigo ◽  
F Bovenzi ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Flow Velocity ◽  
Coronary Flow ◽  
Stress Echocardiography ◽  
Age Groups ◽  
Coronary Flow Velocity Reserve ◽  
Coronary Flow Velocity ◽  
Cutoff Values ◽  
Age And Sex

Abstract Background Coronary flow velocity reserve (CFVR) of left anterior descending artery is useful for risk stratification during stress echocardiography (SE) as an add-on to regional wall motion abnormalities (RWMA), but the age-and sex-dependence of prognostic cutoff values remains unclear. Purpose To provide sex and age-specific prognostic cut-off values which may be needed to account for the physiologic decline of CFVR with age, and sex-related differences in resting flow. Methods In an observational, prospective, multicenter, registry study design, we enrolled from August 2003 to August 2017 in 4 Italian cardiology referral centers with accredited, quality-controlled stress echo laboratory a consecutive sample of 5,577 patients (of them, 2,284 women and 110 aged ≥85 years) referred to the SE lab for known or suspected coronary artery disease, after exclusion of patients with inadequate acoustic window (n=295), premature test interruption (n=105), and lost to follow-up (n=173).All underwent dual imaging (RWMA and CFVR) dipyridamole SE (0.84 mg/kg over 6') and were followed-up. All-cause death and non-fatal myocardial infarction were the main outcome measures. Median follow-up of 20 months (1st quartile 8, 3rd quartile 43 months), Results There were 649 hard events (236 deaths and 413 non-fatal myocardial infarctions), 288 of which occurred in women and 38 in patients ≥85 years. With a ROC analysis, the best prognostic cut-off value for CFVR was almost the same for men (2.03) and women (2.02) and consistent across all age strata (<45 years: 2.03; 45–54 years: 2.04; 45–64 years: 2.03; 65–74 and 75–84 years: 2.0) except for the very elderly (>85 years) who showed an optimal value of 1.90. Independent prognostic indicators were RWMA (HR=5.42, 95% CI=2.42–12.15; p<0.0001) and reduced CFVR (HR=3.26, 95% CI 2.27–3.90; p<0.0001) in patients aged <85 years, and RWMA (HR=5.42, 95% CI=2.42–12.15; p<0.0001) in patients aged >85 years. Best prognostic cut-off value of CFVR Conclusion A sex-independent cut-off value of CFVR ≤2.0 provides the optimal risk stratification across all age groups, except those >85 years in whom a lower cut-off <1.90 is needed. Risk stratification is more effective for all age groups when CFVR is combined with RWMA.

scholarly journals Prognostic value of calcium score and coronary flow velocity reserve in asymptomatic diabetic patients

2015 ◽  
Vol 13 (1) ◽  
Author(s):  
Miodrag Dikic ◽  
Milorad Tesic ◽  
Zeljko Markovic ◽  
Vojislav Giga ◽  
Ana Djordjevic-Dikic ◽  
...  
Keyword(s):  
Flow Velocity ◽  
Coronary Flow ◽  
Prognostic Value ◽  
Calcium Score ◽  
Diabetic Patients ◽  
Coronary Flow Velocity Reserve ◽  
Coronary Flow Velocity
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