Noninvasive Assessment of Lad Coronary Flow Parameters During Exercise Test. 3-Year Prognosis

Assessment of coronary flow is used during pharmacological tests. Nevertheless, supine bicycle tests have allowed the application of coronary flow assessments during exercise. The aim of the study was to define the outcomes of the consecutive cohort in three years period after coronary artery flow velocity analysis during exercise tests. Materials and methods. There is a single center prospective cohort study of 299 patients who underwent a bicycle exercise echocardiography with the analysis of coronary artery flow velocity in left anterior coronary artery (LAD). Coronary flow velocities were measured before and at the peak of exercise at the medium segment of the LAD. In addition, the coronary flow velocity reserve (CFVR) and the differences between the peak and rest velocities (ΔV) were calculated. Two hundred and fifty-nine patients were accessible for follow-up analysis (56 ± 9 years, 167 men). Cardiovascular death, nonfatal myocardial infarction, revascularization or cardiac arrests with cardiopulmonary resuscitation were defined as major adverse cardiac events (MACE). The period after stress test was 3.0 ± 0.1 years. Results. There were 77 patients with MACE. The group with MACE vs the rest patients had a lower velocity in LAD at the peak of exercise (58 ± 30 vs 68 ± 26 cm/s, p < 0.03), ΔV (18 ± 21 vs 35 ± 24 cm/s, p < 0.00002), and CFVR (1.5 ± 0.5 vs 2.0 ± 0.7, p < 0.00002). Among the group with CFVR > 2.1% had myocardial infarction, death or coronary artery bypass grafting in 3-year period. The group with CFVR ≤ 2 had МАСЕ in 40% of cases (p < 0.000001). Conclusion. The analysis of coronary flow in LAD during exercise can be used as a predictor of 3-year outcomes.

стресс-эхокардиография, коронарный резерв, стресс-эхо с физической нагрузкой, визуализация коронарных артерий, прогноз стресс-эхо, stress echocardiography, coronary flow reserve, exercise stress echo, coronary artery visualization, stress echo prognosis

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