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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.

Authors :
Everaars H
de Waard GA
Driessen RS
Danad I
van de Ven PM
Raijmakers PG
Lammertsma AA
van Rossum AC
Knaapen P
van Royen N
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

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.)

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