Abstract 2728: The Prognostic Value Of Coronary Flow Reserve In Patients With Single Vessel Disease And Intermediate Stenosis Severity
Background: Coronary flow reserve (CFR) and regional function can be simultaneously assessed during vasodilator stress echo.
Aim: to assess the additional prognostic value of CFR in patients with single vessel disease and stenosis of intermediate severity.
Methods: 103 patients (68 males; age 66±9) with single vessel disease and stenosis of intermediate (50 to 75%) severity of the left anterior descending artery (n=72) or of right coronary artery (RCA, n=31) underwent stress echocardiography with dipyridamole (up to 0.84 mg/kg), including wall motion analysis by 2-dimensional echocardiography and coronary flow reserve (CFR) evaluation of the affected artery by Doppler. A new regional wall motion abnormality in >or=2 contiguous segments was required for 2-dimensional echocardiographic positivity. CFR was evaluated as the ratio of dipyridamole to peak diastolic coronary blood flow velocity at rest. All patients were followed-up for a median of 29 months.
Results: During follow-up 24 events occurred: 7 nonfatal myocardial infarctions, 17 re-hospitalizations for unstable angina. The 40-month spontaneous event-free survival was higher in patients with normal CFR (see figure⇓). At multivariable analysis, a CFR >2 (hazard ratio [HR] 3.6, 95% CI 1.3–9.8, P < .012), was the only independent prognostic predictor of outcome.
Conclusions: In patients with single vessel disease and intermediate stenosis severity, reduced CFR is associated with a worse outcome, outperforming anatomic and wall motion parameters.