Prognostic role of aortic atherosclerosis and coronary flow reserve in patients with suspected coronary artery disease.
BACKGROUND
The degree of aortic atherosclerosis (AA) and coronary flow reserve (CFR) can be evaluated simultaneously during the same transoesophageal echocardiographic (TEE) examination. The aim of the present study was to assess the relative prognostic value of simultaneously evaluated CFR and AA by TEE in patients with suspected or known coronary artery disease (CAD).


METHODS
The present study comprised 397 inhospital patients with chest pain. All patients underwent a transthoracic echocardiographic study to evaluate left ventricular function and a vasodilator TEE study to evaluate simultaneously CFR and the degree of AA.


RESULTS
Coronary angiography was performed in 292 patients (74%). Significant CAD was less frequent in patients with normal CFR and low-grade AA. During a mean follow-up of 41+/-12 months, 23 patients suffered cardiovascular death (14 sudden cardiac death, 7 heart failure, 2 cardiovascular thrombosis). Univariate analysis yielded age, diabetes, AA grade and CFR as predictors of survival. Multivariate regression analysis showed that only CFR (hazard ratio (HR) 2.9, P<0.02) and diabetes (HR 3.8, P<0.01) were independent predictors of survival.


CONCLUSIONS
It can be said that both CFR and AA grade are associated with poor survival but only CFR is an independent predictor.
Nemes
Attila
A
2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, H-6720 Szeged, Korányi fasor 6, P.O. Box 427, Hungary. nemes@in2nd.szote.u-szeged.hu
Forster
Tamás
T
Geleijnse
Marcel L
ML
Soliman
Osama I I
OI
Cate
Folkert J Ten
FJ
Csanády
Miklós
M
D000328:Adult; D000368:Aged; D001018:Aortic Diseases / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D050197:Atherosclerosis / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D003326:Coronary Circulation / Q000502:physiology*; D017548:Echocardiography, Transesophageal / Q000639:trends; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends