Document Detail

Long-term prognostic significance of coronary flow velocity reserve in patients with significant coronary artery disease not involving the left anterior descending coronary artery (results from the SZEGED study).
MedLine Citation:
PMID:  20486959     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Coronary flow velocity reserve (CFR) by pulsed Doppler echocardiography is a useful hemodynamic index to evaluate the coronary microcirculatory dysfunction in the left anterior descending coronary artery (LAD). The present study was designed to evaluate the long-term predictive value of CFR for mortality in patients with right (RC) and/or left circumflex coronary artery (CX) stenosis without epicardial LAD disease. METHODS: A total of 49 patients with significant RC and/or CX stenosis were enrolled in this prospective follow-up study. All patients had undergone coronary angiography demonstrating significant RC and/or CX stenosis without LAD disease and dipyridamole stress transoesophageal echocardiography as CFR measurement. RESULTS: The success rate of follow-up was 43 out of 49 (88%). During a mean follow-up of 97 +/- 29 months, 14 patients suffered cardiovascular deaths (12 sudden cardiac deaths and 2 strokes), and 1 patient died of pulmonal tumor. Patients who died during the follow-up had significantly lower CFR values (1.85 +/- 0.43 vs. 2.31 +/- 0.57, P < 0.05). Using ROC analysis, CFR <2.09 had the highest accuracy in predicting cardiovascular survival (sensitivity 80%, specificity 57%, area under the curve 73%, P = 0.003). The logistic regression model identified only CFR as an independent predictor of survival (hazard ratio [HR] 6.26, 95% CI of HR 1.23-19.61, P = 0.024). CONCLUSIONS: Long-term prognostic significance of CFR for the prediction of mortality has been demonstrated during a 9-year follow-up in patients with significant coronary artery disease not involving the LAD.
Attila Nemes; Erika Balázs; Szilvia Pintér; Miklós Csanády; Tamás Forster
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  27     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-05-21     Completed Date:  2010-09-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  306-10     Citation Subset:  IM    
Second Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, H-6720 Szeged, Hungary.
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MeSH Terms
Blood Flow Velocity
Cardiomyopathies / physiopathology*,  ultrasonography
Coronary Artery Disease / mortality,  physiopathology*,  ultrasonography
Coronary Circulation
Coronary Vessel Anomalies / ultrasonography
Coronary Vessels / physiopathology*,  ultrasonography
Follow-Up Studies
Multivariate Analysis

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