Impact of coronary revascularization on coronary flow capacity measured by transthoracic Doppler echocardiography in patients with chronic coronary syndrome
Abstract Coronary flow capacity (CFC) integrates quantitative assessment of hyperemic myocardial blood flow and coronary flow reserve. We aimed to evaluate the effect of elective percutaneous coronary revascularization (PCI) on CFC using serial stress transthoracic Doppler echocardiography (STDE). O...
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Nature Portfolio
2024-11-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-024-79896-w |
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| author | Hiroki Ueno Eisuke Usui Masahiro Hoshino Yoshihisa Kanaji Tomoyo Sugiyama Masahiro Hada Tatsuhiro Nagamine Yoshihiro Hanyu Kai Nogami Mirei Setoguchi Kodai Sayama Tomohiro Tahara Kazuki Matsuda Rika Sai Tatsuya Sakamoto Hikaru Shimosato Takahiro Watanabe Takashi Mineo Taishi Yonetsu Tetsuo Sasano Tsunekazu Kakuta |
| author_facet | Hiroki Ueno Eisuke Usui Masahiro Hoshino Yoshihisa Kanaji Tomoyo Sugiyama Masahiro Hada Tatsuhiro Nagamine Yoshihiro Hanyu Kai Nogami Mirei Setoguchi Kodai Sayama Tomohiro Tahara Kazuki Matsuda Rika Sai Tatsuya Sakamoto Hikaru Shimosato Takahiro Watanabe Takashi Mineo Taishi Yonetsu Tetsuo Sasano Tsunekazu Kakuta |
| author_sort | Hiroki Ueno |
| collection | DOAJ |
| description | Abstract Coronary flow capacity (CFC) integrates quantitative assessment of hyperemic myocardial blood flow and coronary flow reserve. We aimed to evaluate the effect of elective percutaneous coronary revascularization (PCI) on CFC using serial stress transthoracic Doppler echocardiography (STDE). Overall, 148 stable patients underwent STDE of the left anterior descending arteries (LAD), before and after elective PCI. Coronary flow velocity reserve (CFVR) was measured using basal and hyperemic diastolic peak velocity (hDPV). Vessels were classified into four CFC categories: severely, moderately, or mildly reduced CFC, and normal flow. Changes in hDPV and CFC status post-PCI, as well as predictors of hDPV increase, were assessed. Despite improvements in fractional flow reserve (FFR) in all cases, 31 cases (20.9%) showed a decrease in hDPV following PCI. Vessels with ischemic CFC, defined as moderately or severely reduced CFC, decreased from 46.6% (69/148) to 19.6% (29/148) post-PCI. Conversely, CFC worsened in 15.5% of patients. Multivariable analysis showed lower pre-PCI hDPV and ischemic CFC were independently predictive of higher-level (> 50%) hDPV increase after PCI. Approximately 20% of FFR-guided LAD PCI resulted in decreased hDPV. CFC deterioration was not uncommon despite FFR improvement. Preprocedural non-invasive STDE may help identify lesions that benefit from revascularization. |
| format | Article |
| id | doaj-art-a6e8393f0b95420da8219dcc8e3829bd |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-a6e8393f0b95420da8219dcc8e3829bd2024-11-24T12:19:55ZengNature PortfolioScientific Reports2045-23222024-11-0114111310.1038/s41598-024-79896-wImpact of coronary revascularization on coronary flow capacity measured by transthoracic Doppler echocardiography in patients with chronic coronary syndromeHiroki Ueno0Eisuke Usui1Masahiro Hoshino2Yoshihisa Kanaji3Tomoyo Sugiyama4Masahiro Hada5Tatsuhiro Nagamine6Yoshihiro Hanyu7Kai Nogami8Mirei Setoguchi9Kodai Sayama10Tomohiro Tahara11Kazuki Matsuda12Rika Sai13Tatsuya Sakamoto14Hikaru Shimosato15Takahiro Watanabe16Takashi Mineo17Taishi Yonetsu18Tetsuo Sasano19Tsunekazu Kakuta20Department of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Interventional Cardiology, Tokyo Medical and Dental UniversityDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalDepartment of Interventional Cardiology, Tokyo Medical and Dental UniversityDepartment of Cardiovascular Medicine, Tokyo Medical and Dental UniversityDepartment of Cardiovascular Medicine, Tsuchiura Kyodo General HospitalAbstract Coronary flow capacity (CFC) integrates quantitative assessment of hyperemic myocardial blood flow and coronary flow reserve. We aimed to evaluate the effect of elective percutaneous coronary revascularization (PCI) on CFC using serial stress transthoracic Doppler echocardiography (STDE). Overall, 148 stable patients underwent STDE of the left anterior descending arteries (LAD), before and after elective PCI. Coronary flow velocity reserve (CFVR) was measured using basal and hyperemic diastolic peak velocity (hDPV). Vessels were classified into four CFC categories: severely, moderately, or mildly reduced CFC, and normal flow. Changes in hDPV and CFC status post-PCI, as well as predictors of hDPV increase, were assessed. Despite improvements in fractional flow reserve (FFR) in all cases, 31 cases (20.9%) showed a decrease in hDPV following PCI. Vessels with ischemic CFC, defined as moderately or severely reduced CFC, decreased from 46.6% (69/148) to 19.6% (29/148) post-PCI. Conversely, CFC worsened in 15.5% of patients. Multivariable analysis showed lower pre-PCI hDPV and ischemic CFC were independently predictive of higher-level (> 50%) hDPV increase after PCI. Approximately 20% of FFR-guided LAD PCI resulted in decreased hDPV. CFC deterioration was not uncommon despite FFR improvement. Preprocedural non-invasive STDE may help identify lesions that benefit from revascularization.https://doi.org/10.1038/s41598-024-79896-w |
| spellingShingle | Hiroki Ueno Eisuke Usui Masahiro Hoshino Yoshihisa Kanaji Tomoyo Sugiyama Masahiro Hada Tatsuhiro Nagamine Yoshihiro Hanyu Kai Nogami Mirei Setoguchi Kodai Sayama Tomohiro Tahara Kazuki Matsuda Rika Sai Tatsuya Sakamoto Hikaru Shimosato Takahiro Watanabe Takashi Mineo Taishi Yonetsu Tetsuo Sasano Tsunekazu Kakuta Impact of coronary revascularization on coronary flow capacity measured by transthoracic Doppler echocardiography in patients with chronic coronary syndrome Scientific Reports |
| title | Impact of coronary revascularization on coronary flow capacity measured by transthoracic Doppler echocardiography in patients with chronic coronary syndrome |
| title_full | Impact of coronary revascularization on coronary flow capacity measured by transthoracic Doppler echocardiography in patients with chronic coronary syndrome |
| title_fullStr | Impact of coronary revascularization on coronary flow capacity measured by transthoracic Doppler echocardiography in patients with chronic coronary syndrome |
| title_full_unstemmed | Impact of coronary revascularization on coronary flow capacity measured by transthoracic Doppler echocardiography in patients with chronic coronary syndrome |
| title_short | Impact of coronary revascularization on coronary flow capacity measured by transthoracic Doppler echocardiography in patients with chronic coronary syndrome |
| title_sort | impact of coronary revascularization on coronary flow capacity measured by transthoracic doppler echocardiography in patients with chronic coronary syndrome |
| url | https://doi.org/10.1038/s41598-024-79896-w |
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