Key result
Non-invasive assessment of coronary flow velocity reserve by transthoracic echocardiography during adenosine infusion was highly feasible (98.2%) and safe, with no major complications and a 43.7% rate of minor, well-tolerated adverse effects in women with suspected or known CAD.
Why the study?
Is noninvasive assessment of coronary flow velocity reserve (CFVR) using transthoracic echocardiography with adenosine infusion feasible and safe in women with suspected or known coronary artery disease?
Observational (n=1,455)
No
Is noninvasive assessment of coronary flow velocity reserve (CFVR) using transthoracic echocardiography with adenosine infusion feasible and safe in women with suspected or known coronary artery disease?
Noninvasive assessment of CFVR using TTE with adenosine is highly feasible and safe in women with suspected or known CAD, with no major complications and manageable minor side effects.
Answers are grounded in this paper and cite their sources.
Supports CFVR testing by TTE in women; leaves open outcome validation before practice change.
BACKGROUND: Microvascular coronary impairment, defined as reduced coronary flow reserve, represents the predominant etiologic mechanism of ischemia in women with chest pain and no obstructive coronary artery disease. Transthoracic echocardiography (TTE) is a noninvasive method for assessing coronary flow velocity reserve (CFVR) in the left anterior descending coronary artery (LAD). The purpose of this investigation was to define the safety profile, feasibility, adverse events, and rate of complications of the test in women with suspected CAD. METHODS: We evaluated CFVR in LAD with TTE during adenosine infusion in 1455 women aged 66.4±11.9 years. RESULTS: A complete CFVR study was achieved in 1429 pts (feasibility 98.2%), the test being performed also in the early phase of acute coronary syndrome and on obese patients. Minor symptoms or adverse effects occurred in 43.7% of patients not requiring test termination: hyperpnea (16.7%), flushing (9.4%), atypical chest pain (9.9%), headache (6.6%), minor arrhythmias (2.9%), chest pain with EKG changes (1.5%) were the symptoms reported. No major complications were observed. CONCLUSIONS: Noninvasive assessment of CFVR in LAD by TTE is a very feasible method with very low incidence of adverse events and complications in women with suspected or known CAD. It is safe and can be used when evaluating female patients with atherosclerotic LAD disease or with coronary microvascular impairment.
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Montisci et al. (2017) conducted an observational in Suspected or known coronary artery disease (n=1,455). Non-invasive assessment of coronary flow velocity reserve (CFVR) with transthoracic echocardiography during adenosine infusion was evaluated on Feasibility of complete CFVR study. Non-invasive assessment of coronary flow velocity reserve by transthoracic echocardiography during adenosine infusion was highly feasible (98.2%) and safe, with no major complications and a 43.7% rate of minor, well-tolerated adverse effects in women with suspected or known CAD.
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