Author + information
- Received April 12, 2018
- Revision received July 9, 2018
- Accepted July 10, 2018
- Published online October 15, 2018.
- Henk Everaars, MDa,∗,
- Guus A. de Waard, MDa,∗,
- Roel S. Driessen, MDa,
- Ibrahim Danad, MDa,
- Peter M. van de Ven, PhDb,
- Pieter G. Raijmakers, MD, PhDc,
- Adriaan A. Lammertsma, PhDc,
- Albert C. van Rossum, MD, PhDa,
- Paul Knaapen, MD, PhDa and
- Niels van Royen, MD, PhDa,d,∗ ()
- aDepartment of Cardiology, VU University Medical Center, Amsterdam, the Netherlands
- bDepartment of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
- cDepartment of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
- dDepartment of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
- ↵∗Address for correspondence:
Prof. Niels van Royen, Radboud University Medical Center, Department of Cardiology, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, the Netherlands.
Objectives This study sought to compare Doppler flow velocity reserve (CFRDoppl) and thermodilution-derived coronary flow reserve (CFRthermo) head-to-head with the gold standard for quantification of myocardial perfusion, [15O]H2O positron emission tomography (PET).
Background Coronary flow reserve (CFR) is an important parameter for assessing coronary vascular function. To date, 2 techniques are available for invasive assessment of CFR: Doppler flow velocity and thermodilution. Although these techniques have been compared with each other, neither has been compared with [15O]H2O PET perfusion imaging.
Methods CFR was assessed in 98 vessels of 40 consecutive stable patients with suspected coronary artery disease. Patients underwent [15O]H2O PET, followed by invasive angiography in conjunction with simultaneous measurements of fractional flow reserve, CFRDoppl, and CFRthermo. Both normal and obstructed arteries were included.
Results The quality of Doppler flow velocity traces was significantly lower than that of thermodilution curves (p < 0.001). A moderate correlation was observed between CFRDoppl and CFRthermo (r = 0.59; p < 0.001). CFRDoppl correlated well with PET-derived CFR (CFRPET) (r = 0.82; p < 0.001). In contrast, the correlation between CFRthermo and CFRPET was only modest (r = 0.55; p < 0.001). This difference in correlation with CFRPET was significant (t = 4.9; df = 95; p < 0.001). Bland-Altman analysis revealed a tendency of CFRthermo to overestimate flow reserve at higher values.
Conclusions Coronary flow reserve, determined using Doppler flow velocity, has superior agreement with [15O]H2O PET in comparison with CFRthermo.
- coronary flow reserve
- Doppler flow velocity
- mean transit time
- positron emission tomography
↵∗ Drs. Everaars and de Waard contributed equally to this work.
Dr. Lammertsma has received research grants from AVID Medical, Philips Healthcare, F. Hoffmann–La Roche, and the European Commission. Dr. van Royen has received research grants from Philips Healthcare, Abbott, Biotronik, and AstraZeneca. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 12, 2018.
- Revision received July 9, 2018.
- Accepted July 10, 2018.
- 2018 American College of Cardiology Foundation