Coronary flow reserve: Difference between revisions
No edit summary |
m (Robot: Changing Category:Up-To-Date Cardiology to Category:Up-To-Date cardiology) |
||
| (4 intermediate revisions by one other user not shown) | |||
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
Coronary flow reserve is a measure of the ability of the coronary artery to increase coronary blood flow in response to a hyperemic stimulus. A normal coronary flow reserve is a value above 2.0. . In other words, ordinarily the coronary artery can double its blood flow in response to the administration of adenosine. Coronary flow reserve interrogates both the epicardial blockage(s) as well as the resistance in the downstream capillary bed. This is in contrast to fractional flow reserve or FFR which reflects only abnormalities of the epicardial stenosis, and does not reflect abnormalities of the downstream microvascular bed. | |||
==Sensitivity and Specificity== | ==Sensitivity and Specificity== | ||
| Line 12: | Line 13: | ||
* Positive predictive value: 84% to 100% | * Positive predictive value: 84% to 100% | ||
* Negative predictive value: 77% to 95% | * Negative predictive value: 77% to 95% | ||
==CFR in the Setting of ST Elevation MI== | |||
In some studies, a coronary flow reserve greater than 1.3 immediately after reperfusion in the setting of STEMI is predictive of preservation of the microvasculature. | |||
==Complications== | ==Complications== | ||
| Line 24: | Line 28: | ||
{{Circulatory system pathology}} | {{Circulatory system pathology}} | ||
{{WikiDoc Help Menu}} | |||
{{WikiDoc Sources}} | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Up-To-Date cardiology]] | |||
Latest revision as of 20:44, 22 November 2011
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Coronary flow reserve is a measure of the ability of the coronary artery to increase coronary blood flow in response to a hyperemic stimulus. A normal coronary flow reserve is a value above 2.0. . In other words, ordinarily the coronary artery can double its blood flow in response to the administration of adenosine. Coronary flow reserve interrogates both the epicardial blockage(s) as well as the resistance in the downstream capillary bed. This is in contrast to fractional flow reserve or FFR which reflects only abnormalities of the epicardial stenosis, and does not reflect abnormalities of the downstream microvascular bed.
Sensitivity and Specificity
When compared to reversible defects on myocardial perfusion imaging, a coronary flow reserve < 2.0 has:
- Sensitivity: 86% to 92%
- Specificity: 89% to 100%
- Predictive accuracy: 89% to 96%
- Positive predictive value: 84% to 100%
- Negative predictive value: 77% to 95%
CFR in the Setting of ST Elevation MI
In some studies, a coronary flow reserve greater than 1.3 immediately after reperfusion in the setting of STEMI is predictive of preservation of the microvasculature.
Complications
The risk of intracoronary Doppler velocity wire measurements are as follows (n=906):
- Bradycardia: 1.7%
- Coronary spasm: 2%
- Ventricular fibrillation: 0.2%
References