This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Cortigiani, L. Articles by Picano, E. PubMed Articles by Cortigiani, L. Articles by Picano, E.

(Circulation. 2007;116:II_369.)
© 2007 American Heart Association, Inc.

Echocardiography: Evaluation of the Coronary Circulation

Abstract 1748: Prognostic Implication of Coronary Flow Reserve in Diabetic and Nondiabetic Patients with Negative Dipyridamole Stress Echo by Wall Motion Criteria

Lauro Cortigiani¹; Fausto Rigo²; Rosa Sicari³; Sonia Gherardi⁴; Maria Luisa Gianfaldoni⁵; Maurizio Galderisi⁶; Francesco Bovenzi⁷; Eugenio Picano⁸

¹ Lucca Hosp, Lucca, Italy
² Mestre Hosp, Mestre, Italy
³ Institute of Clinical Physiology, Pisa, Italy
⁴ Cesena Hosp, Cesena, Italy
⁵ Empoli Hosp, Empoli, Italy
⁶ Federico II Univ, Naples, Italy
⁷ Lucca Hosp, Lucca, Italy
⁸ Institute of Clinical Physiology, Pisa, Italy

Objectives. Aim of this prospective, multicenter, observational study was to assess the prognostic value of Doppler echocardiographic derived coronary flow reserve (CFR) in diabetic and nondiabetic patients with known or suspected coronary artery disease (CAD) and negative dipyridamole stress echo.

Methods. The study group consisted of 1130 patients (207 diabetics) with known (n=418) or suspected (n=712) CAD and negative stress echo by wall motion criteria. All underwent dipyridamole (up to 0.84 mg/kg over 6') echo with CFR evaluation of left anterior descending artery by Doppler. A value of CFR <2.0 was considered abnormal.

Results. CFR was normal in 821 (63%) and abnormal in 309 (27%) patients. During a median follow-up of 16 months, 98 events (8 deaths, 24 STEMI, and 66 NSTEMI) occurred. In addition, 89 patients underwent revascularization and were censored. Multivariable prognostic indicators were abnormal CFR (HR=4.95; 95% CI=3.26–7.50; p<0.0001), antianginal therapy at the time of testing (HR=1.96; 95% CI=1.29 –2.98; p=0.002), age (HR=1.02; 95% CI=1.00–1.04; p=0.02), and resting wall motion abnormalities (HR=1.50; 95% CI=1.00–2.25; p=0.05). The 36-month event rate was lower (p<0.0001) for either diabetics and nondiabetics with normal CFR as compard to diabetics and nondiabetics with abnormal CFR (Figure).

Conclusion. CFR provides effective prognostic information in diabetic and nondiabetic patients with known or suspected CAD and negative dipyridamole stress echo. In particular, a reduced CFR is associated with worse outcome in both populations.

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Cortigiani, L. Articles by Picano, E. PubMed Articles by Cortigiani, L. Articles by Picano, E.