Prognostic Value of Coronary Flow Reserve Obtained on Dobutamine Stress Echocardiography and its Correlation with Target Heart Rate

Abstract Background: Normal coronary flow velocity reserve (CFVR) (≥ 2) obtained in the left anterior descending coronary artery (LAD) from transthoracic echocardiography is associated with a good prognosis, but there is no study correlating CFVR with submaximal target heart rate (HR). Objective: To evaluate the prognostic value of CFVR obtained in the LAD of patients with preserved (>50%) left ventricular ejection fraction (LVEF) who completed a dobutamine stress echocardiography (DSE), considering target HR. Methods: Prospective study of patients with preserved LVEF and CFVR obtained in the LAD who completed DSE. In Group I (GI = 31), normal CFVR was obtained before achieving target HR, and, in Group II (GII = 28), after that. Group III (G III=24) reached target HR, but CFVR was abnormal. Death, acute coronary insufficiency, coronary intervention, coronary angiography without further intervention, and hospitalization were considered events. Results: In 28 ± 4 months, there were 18 (21.6%) events: 6% (2/31) in GI, 18% (5/28) in GII, and 46% (11/24) in GIII. There were 4 (4.8%) deaths, 6 (7.2%) coronary interventions and 8 (9.6%) coronary angiographies without further intervention. In event-free survival by regression analysis, GIII had more events than GI (p < 0.001) and GII (p < 0.045), with no difference between GI and GII (p = 0.160). After adjustment, the only difference was between GIII and GI (p = 0.012). Conclusion: In patients with preserved LVEF and who completed their DSE, normal CFVR obtained before achieving target HR was associated with better prognosis.

Bibliographic Details

Main Authors:	Abreu,José Sebastião de, Rocha,Eduardo Arrais, Machado,Isadora Sucupira, Parahyba,Isabelle Oliveira, Rocha,Thaís de Brito, Paes,Fernando José Villar Nogueira, Diogenes,Tereza Cristina Pinheiro, Abreu,Marília Esther Benevides de, Farias,Ana Gardenia Liberato Ponte, Carneiro,Marcia Maria, Paes Junior,José Nogueira
Format:	Digital revista
Language:	English
Published:	Sociedade Brasileira de Cardiologia - SBC 2017
Online Access:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2017000500417
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