Does coronary flow reserve assessed by blood flow velocity analysis reflect absolute coronary flow reserve?

✍ Scribed by Takeuchi, Masaaki ;Nohtomi, Yuichi ;Kuroiwa, Akio

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 372 KB
• Volume: 38
• Category: Article
• ISSN: 0098-6569
• DOI: 10.1002/(sici)1097-0304(199607)38:3<251::aid-ccd6>3.0.co;2-7

✦ Synopsis

Doppler guidewire enables us to m s u r e phasic coronary velocity and has been used for the measurement of coronary flow reseme (CFR). Although CFR Is usuaiiy calculated by the quotient of peak flow velocity during papaverlne infusion and flow velocity at rest, this assumption Is true only H conduit vessel size is constant. To determine the accuracy of measurement of CFR using average peak velocity (APV) with Doppler guidewire, we investigated the influence of intracoronary papaverine on coronary flow velocity and coronary arterial diameter (CAD) and examined the correlation between CFR derived using APV and that derived using coronary blood flow (CBF) In 26 patients with normal coronary arteries. We measured phasic coronary flow velocity, and performed quantitative coronary angiography in the proximal lett coronary artery at control and during 10 mg of intracoronary papaverine. Compared to control value, papaverine induced a signHicant increase in APV (% increase: 182 f 101%; RO.001). Papaverine also SignHicantiy Increased CAD (16 f 10%; P<O.001). Thus, CFR derived from APV was significantly lower than that derived from CBF (2.8 f 1.0 vs. 4.0 f 1.5, P<O.OOl). Although there was a significantly strong positive correlation between these two methods (R2 = 0.83, P<O.OOl), there was also considerable variability with regard to predicting one variable from the other. These results suggest the importance of standardizing the conditions in which coronary flow velocity is measured with regard to either controlling or measuring changes in epicardial coronary arterial diameter during changes In distal resistance veb sel tone.