Prognostic value of transthoracic coronary flow reserve in medically treated patients with proximal left anterior descending artery stenosis of intermediate severity
被引:24
作者:
Meimoun, Patrick
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机构:
Ctr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Ctr Hosp Compiegne, Intens Care Unit, F-60200 Compiegne, FranceCtr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Meimoun, Patrick
[1
,2
]
Benali, Tahar
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机构:
Ctr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Ctr Hosp Compiegne, Intens Care Unit, F-60200 Compiegne, FranceCtr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Benali, Tahar
[1
,2
]
Elmkies, Frederic
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机构:
Ctr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Ctr Hosp Compiegne, Intens Care Unit, F-60200 Compiegne, FranceCtr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Elmkies, Frederic
[1
,2
]
Sayah, Smain
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Ctr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Ctr Hosp Compiegne, Intens Care Unit, F-60200 Compiegne, FranceCtr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Sayah, Smain
[1
,2
]
Luycx-Bore, Anne
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机构:
Ctr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Ctr Hosp Compiegne, Intens Care Unit, F-60200 Compiegne, FranceCtr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Luycx-Bore, Anne
[1
,2
]
Doutrelan, Luc
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机构:
Ctr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Ctr Hosp Compiegne, Intens Care Unit, F-60200 Compiegne, FranceCtr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Doutrelan, Luc
[1
,2
]
Hamdane, Zemir
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机构:
Ctr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Ctr Hosp Compiegne, Intens Care Unit, F-60200 Compiegne, FranceCtr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Hamdane, Zemir
[1
,2
]
Boulanger, Jacques
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机构:
Ctr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Ctr Hosp Compiegne, Intens Care Unit, F-60200 Compiegne, FranceCtr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Boulanger, Jacques
[1
,2
]
Tribouilloy, Christophe
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机构:
CHU Amiens, Dept Cardiol, INSERM, ERI 12, Amiens, FranceCtr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
Tribouilloy, Christophe
[3
]
机构:
[1] Ctr Hosp Compiegne, Dept Cardiol, F-60200 Compiegne, France
[2] Ctr Hosp Compiegne, Intens Care Unit, F-60200 Compiegne, France
[3] CHU Amiens, Dept Cardiol, INSERM, ERI 12, Amiens, France
来源:
EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY
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2009年
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10卷
/
01期
Prognostic value of transthoracic coronary flow reserve (T-CFR) is not established in patients with left anterior descending artery (LAD) stenosis of intermediate severity. Objective is to determine the prognosis value of T-CFR > 2 in medically treated patients with angiographically intermediate [50-70% QCA (quantitative coronary angiography)] proximal LAD stenosis. Among 110 consecutive patients with intermediate LAD stenosis who underwent prospectively T-CFR in the distal part of the LAD after intravenous administration of adenosine to assess the functional significance of the stenosis, 80 patients had T-CFR > 2 and were treated medically without revascularization (Group 1). Among the 30 patients who had T-CFR < 2, an additional dobutamine stress echocardiography (DSE) was performed: 15 had a negative DSE; were treated medically and served as a comparative group (Group 2), and 15 had a positive DSE; underwent LAD revascularization, and were excluded from further analysis. All patients completed follow-up (16 +/- 10 months). During the follow-up period (range 6-45 months), 76 patients (95%) remained free of death or LAD-related event in Group 1, vs. 12 patients (80%) in Group 2. By Kaplan-Meier method, at 30 months the per cent estimated survival free from death or target vessel-related events was 92 +/- 4% in Group 1 and 44 +/- 22% in Group 2 (P < 0.01). By multivariate analysis, T-CFR remained the only independent predictor of death or LAD-related events. In patients with proximal LAD stenosis of intermediate severity and T-CFR > 2, deferral of revascularization is associated with low event rate.