Correlation Between Frame Count Reserve and Coronary Flow Velocity Reserve Assessed by Intracoronary Doppler Wire.

초록

Background: The corrected TIMI frame count (CTFC) was related to epicardial coronary blood flow, and coronary flow velocity reserve (CFVR) might be measured easily by CTFC during angiography. However, the feasibility and usefulness of CFVR assessed by CTFC, known as frame count reserve (FCR), has not been clearly evaluated, and a previous study had some limitations relating to inducing and capturing maximal hyperemia. We compared the FCR and CFVR by intracoronary (IC) Doppler wire. Methods: In 10 patients with coronary artery disease, 20 cases (left anterior descending coronary artery, 18; right coronary artery, 1; left circumflex coronary artery, 1) of FCR were evaluated. In patients who underwent percutaneous coronary intervention (PCI), we measured FCR before and after PCI. For evaluating adequate hyperemic frame count during the maximal hyperemic state, coronary vasodilation was induced successively by an IC bolus injection of high-dose adenosine (60–80 mg) and an intravenous (IV) continuous infusion of adenosine (140 mg/min per kg). FCR was defined as the ratio of frame count at baseline and frame count at hyperemic state. We also measured CFVR by IC Doppler wire (FloWire, Cardiometrics, Mountain View, CA, USA), and hyperemia was successively induced by IC bolus injection and IV infusion. Results: Baseline CFTC was 20.4 10.2. The hyperemic frame count induced by the IV infusion method was smaller than that by the IC injection method (8.17 3.19 vs 9.65 3.00, p 0.016), and FCR measured by the IV infusion method was larger than that measured by the IC bolus injection method (2.50 0.93 vs 2.14 0.94, p 0.005). CFVR measured by the IV infusion method was larger than that measured by the IC injection method (2.78 0.91 vs 2.54 0.95, p 0.018) or FCR measured by the IV infusion method (p 0.013). However, there was no significant difference between FCR measured by the IV infusion method and CFVR measured by the IC