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Doppler Flow Velocity and Thermodilution to Assess Coronary Flow Reserve: A Head-to-Head Comparison With [ 15 O]H 2 O PET.
- Source :
-
JACC. Cardiovascular interventions [JACC Cardiovasc Interv] 2018 Oct 22; Vol. 11 (20), pp. 2044-2054. Date of Electronic Publication: 2018 Sep 26. - Publication Year :
- 2018
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Abstract
- Objectives: This study sought to compare Doppler flow velocity reserve (CFR <subscript>Doppl</subscript> ) and thermodilution-derived coronary flow reserve (CFR <subscript>thermo</subscript> ) head-to-head with the gold standard for quantification of myocardial perfusion, [ <superscript>15</superscript> O]H <subscript>2</subscript> O positron emission tomography (PET).<br />Background: Coronary flow reserve (CFR) is an important parameter for assessing coronary vascular function. To date, 2 techniques are available for invasive assessment of CFR: Doppler flow velocity and thermodilution. Although these techniques have been compared with each other, neither has been compared with [ <superscript>15</superscript> O]H <subscript>2</subscript> O PET perfusion imaging.<br />Methods: CFR was assessed in 98 vessels of 40 consecutive stable patients with suspected coronary artery disease. Patients underwent [ <superscript>15</superscript> O]H <subscript>2</subscript> O PET, followed by invasive angiography in conjunction with simultaneous measurements of fractional flow reserve, CFR <subscript>Doppl</subscript> , and CFR <subscript>thermo</subscript> . Both normal and obstructed arteries were included.<br />Results: The quality of Doppler flow velocity traces was significantly lower than that of thermodilution curves (p < 0.001). A moderate correlation was observed between CFR <subscript>Doppl</subscript> and CFR <subscript>thermo</subscript> (r = 0.59; p < 0.001). CFR <subscript>Doppl</subscript> correlated well with PET-derived CFR (CFR <subscript>PET</subscript> ) (r = 0.82; p < 0.001). In contrast, the correlation between CFR <subscript>thermo</subscript> and CFR <subscript>PET</subscript> was only modest (r = 0.55; p < 0.001). This difference in correlation with CFR <subscript>PET</subscript> was significant (t = 4.9; df = 95; p < 0.001). Bland-Altman analysis revealed a tendency of CFR <subscript>thermo</subscript> to overestimate flow reserve at higher values.<br />Conclusions: Coronary flow reserve, determined using Doppler flow velocity, has superior agreement with [ <superscript>15</superscript> O]H <subscript>2</subscript> O PET in comparison with CFR <subscript>thermo</subscript> .<br /> (Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Blood Flow Velocity
Coronary Artery Disease physiopathology
Coronary Stenosis physiopathology
Female
Humans
Male
Middle Aged
Observer Variation
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Severity of Illness Index
Thermodilution
Coronary Artery Disease diagnostic imaging
Coronary Stenosis diagnostic imaging
Echocardiography, Doppler
Fractional Flow Reserve, Myocardial
Myocardial Perfusion Imaging methods
Oxygen Radioisotopes administration & dosage
Positron-Emission Tomography
Radiopharmaceuticals administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1876-7605
- Volume :
- 11
- Issue :
- 20
- Database :
- MEDLINE
- Journal :
- JACC. Cardiovascular interventions
- Publication Type :
- Academic Journal
- Accession number :
- 30268877
- Full Text :
- https://doi.org/10.1016/j.jcin.2018.07.011