Doppler Flow Velocity and Thermodilution to Assess Coronary Flow Reserve A Head-to-Head Comparison With [15O]H2O PET
Doppler Flow Velocity and Thermodilution to Assess Coronary Flow Reserve A Head-to-Head Comparison With [15O]H2O PET
复制标题
DOI：
10.1016/j.jcin.2018.07.011
复制
发表时间：
2018-10-22
影响因子：
11.3
通讯作者：
van Royen, Niels
中科院分区：
文献类型：
--
作者：
Everaars, Henk;de Waard, Guus A.;van Royen, Niels
目的 本研究旨在将多普勒血流速度储备 (CFRDoppl) 和热稀释冠状动脉血流储备 (CFRthermo) 与心肌灌注量化的金标准 [O-15] H2O 正电子发射断层扫描 (PET) 进行正面比较。 背景 冠状动脉血流储备 (CFR) 是评估冠状血管功能的重要参数。迄今为止，有 2 种技术可用于 CFR 的侵入性评估：多普勒流速和热稀释。虽然这些技术已经相互比较，但都没有与[O-15] H2O PET灌注成像进行比较。方法对40名连续稳定的疑似冠状动脉疾病患者的98条血管进行CFR评估。患者接受[O-15] H2O PET，随后进行侵入性血管造影，同时测量血流储备分数、CFRDoppl 和 CFRthermo。正常动脉和阻塞动脉均包括在内。 结果 多普勒流速迹线的质量显着低于热稀释曲线的质量（p < 0.001）。 CFRDoppl 和 CFRthermo 之间观察到中等相关性（r = 0.59；p < 0.001）。 CFRDoppl 与 PET 衍生的 CFR (CFRPET) 相关性良好 (r = 0.82；p < 0.001)。相比之下，CFRthermo 和 CFRPET 之间的相关性不大（r = 0.55；p < 0.001）。这种与 CFRPET 相关性的差异显着（t = 4.9；df = 95；p < 0.001）。 Bland-Altman 分析揭示了 CFRthermo 在较高值时高估血流储备的倾向。 结论 与 CFRthermo 相比，使用多普勒血流速度确定的冠状动脉血流储备与 [O-15] H2O PET 具有更好的一致性。 (c) 2018 年，美国心脏病学会基金会。
OBJECTIVES This study sought to compare Doppler flow velocity reserve (CFRDoppl) and thermodilution-derived coronary flow reserve (CFRthermo) head-to-head with the gold standard for quantification of myocardial perfusion, [O-15] H2O positron emission tomography (PET).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 [O-15] H2O PET perfusion imaging.METHODS CFR was assessed in 98 vessels of 40 consecutive stable patients with suspected coronary artery disease. Patients underwent [O-15] H2O PET, followed by invasive angiography in conjunction with simultaneous measurements of fractional flow reserve, CFRDoppl, and CFRthermo. Both normal and obstructed arteries were included.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 CFRDoppl and CFRthermo (r = 0.59; p < 0.001). CFRDoppl correlated well with PET-derived CFR (CFRPET) (r = 0.82; p < 0.001). In contrast, the correlation between CFRthermo and CFRPET was only modest (r = 0.55; p < 0.001). This difference in correlation with CFRPET was significant (t = 4.9; df = 95; p < 0.001). Bland-Altman analysis revealed a tendency of CFRthermo to overestimate flow reserve at higher values.CONCLUSIONS Coronary flow reserve, determined using Doppler flow velocity, has superior agreement with [O-15] H2O PET in comparison with CFRthermo. (c) 2018 by the American College of Cardiology Foundation.