Reduced coronary flow reserve in patients with congestive heart failure assessed by transthoracic Doppler echocardiography
Section snippets
Patients
In all, 15 patients (6 men, 9 women) with CHF were included in this study. Of these, 7 patients had dilated cardiomyopathy (DCM) and the remaining 8 patients had hypertensive heart disease (HHD). Patient age ranged from 39 to 81 years with a mean age of 64 ± 14 years. All patients had orthopnea at the time of admission and chest radiograph revealed lung congestion. Patients with atrial fibrillation, using catecholamine, and undergoing intubation were excluded from this study. All patients
Echocardiographic data
The echocardiographic data in both conditions before and after improvement of CHF are presented in Table 1. Although there were no significant differences in LVEF before and after improvement of CHF, LVDd, LV end-systolic dimension, LVEDV, and LV end-systolic volume were significantly greater during CHF compared with after improvement of CHF (Table 1). Furthermore, LV-DT was significantly shorter during CHF compared with after improvement of CHF (Table 1).
CFV data and hemodynamic data
Coronary flow and CFV data in both
Discussion
In this study, we demonstrated that CFR was restricted for patients with CHF because of an increase in basal MDV of the coronary flow. Reduction of CFR changed for the better after improvement of CHF, because basal mean diastolic CFV was reduced without any change in maximal hyperemic mean diastolic CFV. LV preload, which was demonstrated by the size of LVDd and LVEDV, was also significantly reduced after improvement of CHF, but there was no significant difference in LVEF. HR became lower
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Cited by (24)
Factors associated with discordance between fractional flow reserve and resting full-cycle ratio
2022, Journal of CardiologyCitation Excerpt :In addition, a level of log-transformed BNP was higher in Group 3 than in Group 2 (FFR ≤0.80 and RFR >0.89) in the present study. It is known that in patients with heart failure, typically in those with reduced LVEF, resting coronary flow velocity is higher [25], whereas previous studies demonstrated that heart failure and preserved LVEF was associated with coronary microvascular dysfunction [26], resulting in reduced coronary flow reserve in heart failure patients [27]. Thus, a higher level of log-transformed BNP in Group 3 (FFR >0.80 and RFR ≤0.89) may be reasonable, supported by the echocardiographic findings including higher values of LVDDI, LVDSI, and E/e' and lower LVEF.
Evaluation of bi-ventricular coronary flow patterns using high-frequency ultrasound in mice with transverse aortic constriction
2013, Ultrasound in Medicine and BiologyCoronary perivascular fibrosis is associated with impairment of coronary blood flow in patients with non-ischemic heart failure
2012, Journal of CardiologyCitation Excerpt :The presence of microvascular dysfunction after acute myocardial infarction is now considered to be an important prognostic factor [33]. Coronary flow reserve, as an indicator of coronary blood flow, has been demonstrated to be impaired during acute phase of HF, and to be strongly correlated with the mortality of HF patients [9,10]. Thus, it is important to improve coronary blood flow in non-ischemic HF patients as well and to pay much attention to perivascular fibrosis as it is an important determinant of coronary blood flow.
Acute Effects of Adaptive Servo Ventilation on Hemodynamics, Coronary Flow, and Flow Reserve in a Patient With Idiopathic Dilated Cardiomyopathy
2012, Canadian Journal of CardiologyCitation Excerpt :In this case, decreased heart rate and left ventricular end-diastolic pressure (LVEDP) which partially related with decreased myocardial oxygen consumption were also derived using ASV. In addition, Neishi et al.5 reported that CFVR was mainly determined by heart rate and LVEDP in heart failure patients. Taken together, our present report suggested that ASV might decrease myocardial oxygen demand, which was represented by the decreased resting coronary flow velocity (the improvement of CFVR) using ASV.
Coronary Flow Reserve in Idiopathic Dilated Cardiomyopathy: Relation with Left Ventricular Wall Stress, Natriuretic Peptides, and Endothelial Dysfunction
2009, Journal of the American Society of Echocardiography