Coronary Flow Reserve in the Left Anterior Descending Artery Patients, Diagnostic and Prognostic Value of Doppler Echocardiogrphy

Introduction: Coronary arteriography is the usual method to evaluate the coronary anatomy. However; it is well known that it cannot assess the functional consequences of arterial lumen narrowing but coronary flow reserve can assess them.Aim of the Work: The authors sought to determine the best value of Doppler-echocardiography-derived Coronary Flow Reserve (CFR) for detecting ≥75% LAD stenosis.Methods: 30 patients with Proximal LAD stenosis ≥50%, CFR was determined by dipyridamole stress trans-esophageal echo.Exclusion criteria: Any acute MI, end stage malignancy, previous CABG patients, any contraindications for coronary angiography, dipyridamole or TEE.Results: The mean CFR was 1.797±0.355, 18 patients (60%) had limited CFR and 12 patients (40%) had non-limited CFR, 20 (66.7%) patients had LAD stenosis ≥75% while 10 (33.3%) patients had LAD stenosis 75%.By ROC curve analysis, a cut-off point of CFR at 1.93 was sensitive by 70% and specific by 75% for prediction of ≥75% LAD stenosis p 0.006 and area under curve 0.81.There was a significant negative correlation between CFR and LAD stenosis.Conclusion: Doppler echo can be used assess coronary flow reserve in patients with intermediate LAD lesions and aid in the decision for angioplasty, however CFR value appeared to be affected with different cardiovascular risk factors.