Current concepts of coronary flow reserve for clinical decision making during cardiac catheterisation

被引:96
作者
Baumgart, D [1 ]
Haude, M [1 ]
Liu, FQ [1 ]
Ge, JB [1 ]
Goerge, G [1 ]
Erbel, R [1 ]
机构
[1] Univ Essen Gesamthsch, Dept Cardiol, Ctr Internal Med, D-4300 Essen 1, Germany
关键词
D O I
10.1016/S0002-8703(98)70194-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Measurements of coronary flow reserve, once used only for research, have gained wide acceptance as an additional diagnostic approach in the decision-making process of diagnostic cardiac catheterization and coronary interventions. Apart from the noninvasive determination of coronary flow reserve, intracoronary Doppler flow wires have facilitated decision making in the catheterization laboratory. Different techniques, unstandardized procedures, and data from uncomparable patient populations have remained a confounding factor. This review examines current concepts of coronary flow reserve as well as methodologic considerations and pitfalls. Applications of coronary flow reserve for periinterventional assessment are evaluated on the background of practical guidance. According to a detailed examination of arterial structure and function, a normal coronary flow reserve exceeds a value of 3.0. Values below 3.0 suggest involvement of microvascular disease caused by functional or structural alterations. The influences of various factors such as age, hemodynamics, hypercholesterolemia, hypertrophy, hypertension, syndrome X, and coronary artery disease are discussed in relation to the effect on coronary flow reserve. From available information, measurements of coronary flow reserve are an adjunct to current interventional technology to optimize individual patient care. Further efforts should be undertaken to incorporate these new methods into our routine clinical decision making.
引用
收藏
页码:136 / 149
页数:14
相关论文
共 104 条
[1]   EFFECT OF MAXIMAL CORONARY VASODILATION ON TRANSMURAL MYOCARDIAL PERFUSION DURING TACHYCARDIA IN AWAKE DOG [J].
BACHE, RJ ;
COBB, FR .
CIRCULATION RESEARCH, 1977, 41 (05) :648-653
[2]   EFFECT OF INTRACORONARY INJECTION OF CONTRAST-MEDIUM UPON CORONARY BLOOD-FLOW [J].
BASSAN, M ;
GANZ, W ;
MARCUS, HS ;
SWAN, HJC .
CIRCULATION, 1975, 51 (03) :442-445
[3]  
BASSINGTHWAIGHT.JB, 1984, HDB PHYSL 2, P549
[4]  
Baumgart D., 1997, Journal of the American College of Cardiology, V29, p126A
[5]   A PROISCHAEMIC ACTION OF NISOLDIPINE - RELATIONSHIP TO A DECREASE IN PERFUSION-PRESSURE AND COMPARISON TO DIPYRIDAMOLE [J].
BAUMGART, D ;
EHRING, T ;
HEUSCH, G .
CARDIOVASCULAR RESEARCH, 1993, 27 (07) :1254-1259
[6]  
BAUMGART D, 1996, J AM COLL CARDIOL S, V27, P335
[7]  
BAUMGART D, 1996, CIRCULATION S1, V94, P63
[8]   NONINVASIVE QUANTIFICATION OF REGIONAL MYOCARDIAL FLOW RESERVE IN PATIENTS WITH CORONARY ATHEROSCLEROSIS USING N-13 AMMONIA POSITRON EMISSION TOMOGRAPHY - DETERMINATION OF EXTENT OF ALTERED VASCULAR REACTIVITY [J].
BEANLANDS, RSB ;
MUZIK, O ;
MELON, P ;
SUTOR, R ;
SAWADA, S ;
MULLER, D ;
BONDIE, D ;
HUTCHINS, GD ;
SCHWAIGER, M .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1995, 26 (06) :1465-1475
[9]   PROLONGED IMPAIRMENT OF CORONARY VASODILATION AFTER REVERSIBLE ISCHEMIA - EVIDENCE FOR MICROVASCULAR STUNNING [J].
BOLLI, R ;
TRIANA, JF ;
JEROUDI, MO .
CIRCULATION RESEARCH, 1990, 67 (02) :332-343
[10]  
BROWN BG, 1985, AM J CARDIOL, V56, pE23