TY - JOUR
T1 - Impact of clinical and haemodynamic factors on coronary flow reserve and invasive coronary flow capacity in non-obstructed coronary arteries
T2 - a patient-level pooled analysis of the DEBATE and ILIAS studies
AU - Stegehuis, Valérie Elise
AU - Wijntjens, Gilbert W M
AU - Bax, Matthijs
AU - Meuwissen, Martijn
AU - Chamuleau, Steven A J
AU - Voskuil, Michiel
AU - Koch, Karel T
AU - Di Mario, Carlo
AU - Vrints, Christiaan
AU - Haude, Michael
AU - Board, Ei Statistical
AU - Serruys, Patrick W
AU - Piek, Jan J
AU - van de Hoef, Tim P
N1 - Funding Information:
The ILIAS (Intermediate Lesions: Intracoronary flow Assessment versus 99mTc-MIBI SPECT) study was supported by the Dutch Health Insurance Board (grant 96-036) and by a grant from the Netherlands Heart Foundation (grant 2000.090).
Funding Information:
J.J. Piek is a clinical investigator sponsored by the Netherlands Heart Foundation (grant nos. D96.020 and 2000.090). The other authors have no conflicts of interest to declare. The Guest Editor is a consultant for Edwards Lifesciences.
Publisher Copyright:
© Europa Digital & Publishing 2021. All rights reserved.
PY - 2021/4/2
Y1 - 2021/4/2
N2 - AIMS: Coronary flow reserve (CFR) is a physiological index for the assessment of myocardial flow impairment due to focal or microcirculatory coronary artery disease (CAD). Coronary flow capacity (CFC) is another flow-based concept in diagnosing ischaemic heart disease, based on hyperaemic average peak velocity (hAPV) and CFR. We evaluated clinical and haemodynamic factors which potentially influence CFR and CFC in non-obstructed coronary arteries.METHODS AND RESULTS: Intracoronary Doppler flow velocity measurements to obtain CFR and CFC were performed after inducing hyperaemia in 390 non-obstructed vessels of patients who were scheduled for elective percutaneous coronary intervention (PCI) of another vessel. Akaike's information criterion (AIC) revealed age, female gender, history of myocardial infarction, hypercholesterolaemia, diastolic blood pressure, oral nitrates and rate pressure product as independent predictors of CFR and CFC. After regression analysis, age and female gender were associated with lower CFR and age was associated with worse CFC in angiographically non-obstructed vessels.CONCLUSIONS: Age and female gender are associated with lower CFR, and age with worse CFC in an angiographically non-obstructed coronary artery. CFC seems to be less sensitive to variations in clinical and haemodynamic parameters than CFR and is therefore a promising tool in contemporary clinical decision making in the cardiac catheterisation laboratory.
AB - AIMS: Coronary flow reserve (CFR) is a physiological index for the assessment of myocardial flow impairment due to focal or microcirculatory coronary artery disease (CAD). Coronary flow capacity (CFC) is another flow-based concept in diagnosing ischaemic heart disease, based on hyperaemic average peak velocity (hAPV) and CFR. We evaluated clinical and haemodynamic factors which potentially influence CFR and CFC in non-obstructed coronary arteries.METHODS AND RESULTS: Intracoronary Doppler flow velocity measurements to obtain CFR and CFC were performed after inducing hyperaemia in 390 non-obstructed vessels of patients who were scheduled for elective percutaneous coronary intervention (PCI) of another vessel. Akaike's information criterion (AIC) revealed age, female gender, history of myocardial infarction, hypercholesterolaemia, diastolic blood pressure, oral nitrates and rate pressure product as independent predictors of CFR and CFC. After regression analysis, age and female gender were associated with lower CFR and age was associated with worse CFC in angiographically non-obstructed vessels.CONCLUSIONS: Age and female gender are associated with lower CFR, and age with worse CFC in an angiographically non-obstructed coronary artery. CFC seems to be less sensitive to variations in clinical and haemodynamic parameters than CFR and is therefore a promising tool in contemporary clinical decision making in the cardiac catheterisation laboratory.
KW - Clinical research
KW - Clinical trials
KW - Other technique
KW - Stable angina
UR - http://www.scopus.com/inward/record.url?scp=85089308533&partnerID=8YFLogxK
U2 - 10.4244/EIJ-D-19-00774
DO - 10.4244/EIJ-D-19-00774
M3 - Article
C2 - 31951205
SN - 1774-024X
VL - 16
SP - e1503-e1510
JO - EuroIntervention
JF - EuroIntervention
IS - 18
ER -