Doppler Flow Velocity and Thermodilution to Assess Coronary Flow Reserve: A Head-to-Head Comparison With [15O]H2O PET

Henk Everaars; Guus A de Waard; Roel S Driessen; Ibrahim Danad; Peter M van de Ven; Pieter G Raijmakers; Adriaan A Lammertsma; Albert C van Rossum; Paul Knaapen; Niels van Royen

doi:https://doi.org/10.1016/j.jcin.2018.07.011

Doppler Flow Velocity and Thermodilution to Assess Coronary Flow Reserve: A Head-to-Head Comparison With [15O]H2O PET

Henk Everaars, Guus A de Waard, Roel S Driessen, Ibrahim Danad, Peter M van de Ven, Pieter G Raijmakers, Adriaan A Lammertsma, Albert C van Rossum, Paul Knaapen, Niels van Royen

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

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.

Original language	English
Pages (from-to)	2044-2054
Number of pages	11
Journal	JACC Cardiovascular Interventions
Volume	11
Issue number	20
DOIs	https://doi.org/10.1016/j.jcin.2018.07.011
Publication status	Published - 22 Oct 2018

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https://doi.org/10.1016/j.jcin.2018.07.011

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Everaars, H., de Waard, G. A., Driessen, R. S., Danad, I., van de Ven, P. M., Raijmakers, P. G., Lammertsma, A. A., van Rossum, A. C., Knaapen, P., & van Royen, N. (2018). Doppler Flow Velocity and Thermodilution to Assess Coronary Flow Reserve: A Head-to-Head Comparison With [15O]H2O PET. JACC Cardiovascular Interventions, 11(20), 2044-2054. https://doi.org/10.1016/j.jcin.2018.07.011

@article{8f67ec9395d2465783f329fb6b693d7e,

title = "Doppler Flow Velocity and Thermodilution to Assess Coronary Flow Reserve: A Head-to-Head Comparison With [15O]H2O PET",

abstract = "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.",

author = "Henk Everaars and {de Waard}, {Guus A} and Driessen, {Roel S} and Ibrahim Danad and {van de Ven}, {Peter M} and Raijmakers, {Pieter G} and Lammertsma, {Adriaan A} and {van Rossum}, {Albert C} and Paul Knaapen and {van Royen}, Niels",

year = "2018",

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language = "English",

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publisher = "Elsevier Inc.",

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Everaars, H , de Waard, GA , Driessen, RS , Danad, I, van de Ven, PM, Raijmakers, PG , Lammertsma, AA , van Rossum, AC , Knaapen, P & van Royen, N 2018, 'Doppler Flow Velocity and Thermodilution to Assess Coronary Flow Reserve: A Head-to-Head Comparison With [15O]H2O PET', JACC Cardiovascular Interventions, vol. 11, no. 20, pp. 2044-2054. https://doi.org/10.1016/j.jcin.2018.07.011

TY - JOUR

T1 - Doppler Flow Velocity and Thermodilution to Assess Coronary Flow Reserve

T2 - A Head-to-Head Comparison With [15O]H2O PET

AU - Everaars, Henk

AU - de Waard, Guus A

AU - Driessen, Roel S

AU - Danad, Ibrahim

AU - van de Ven, Peter M

AU - Raijmakers, Pieter G

AU - Lammertsma, Adriaan A

AU - van Rossum, Albert C

AU - Knaapen, Paul

AU - van Royen, Niels

PY - 2018/10/22

Y1 - 2018/10/22

N2 - 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.

AB - 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.

U2 - https://doi.org/10.1016/j.jcin.2018.07.011

DO - https://doi.org/10.1016/j.jcin.2018.07.011

M3 - Article

C2 - 30268877

SN - 1936-8798

VL - 11

SP - 2044

EP - 2054

JO - JACC Cardiovascular Interventions

JF - JACC Cardiovascular Interventions

IS - 20

ER -