Related Experiment Video
Updated: Feb 8, 2026
Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice
Published on: April 13, 2015
Effects of coronary revascularization on global coronary flow reserve in stable coronary artery disease
Tadao Aikawa1, Masanao Naya1, Masahiko Obara1
1Department of Cardiovascular Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, Japan.
Insights
Coronary revascularization, particularly coronary artery bypass grafting (CABG), significantly improves coronary flow reserve (CFR) in patients with coronary artery disease (CAD). The extent of revascularization directly correlates with the magnitude of CFR improvement.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Coronary flow reserve (CFR) is a key prognostic indicator in coronary artery disease (CAD).
- The impact of revascularization procedures on CFR remains incompletely understood.
- Assessing CFR provides integrated insights into the entire coronary vasculature.
Purpose of the Study:
- To evaluate the effects of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) on CFR.
- To determine if revascularization strategies can improve CFR in patients with stable CAD.
- To correlate the degree of revascularization with changes in CFR.
Main Methods:
- Prospective, multicentre observational study.
- CFR measured using 15O-water positron emission tomography at baseline and 6 months post-intervention.
- Patients received optimal medical therapy (OMT) alone, PCI, or CABG.
- SYNTAX and Leaman scores assessed for revascularization completeness.
Main Results:
- Baseline CFR negatively correlated with SYNTAX and Leaman scores.
- CABG significantly increased CFR overall.
- In patients with CFR < 2.0, both PCI and CABG led to significant CFR increases.
- Reduced SYNTAX and Leaman scores post-PCI/CABG independently predicted CFR improvement.
Conclusions:
- Coronary revascularization effectively improves reduced CFR in obstructive CAD.
- The degree of improvement in CFR is directly related to the reduction in angiographic CAD burden achieved by revascularization.
Aims:
Coronary flow reserve (CFR) is an integrated measure of the entire coronary vasculature, and is a powerful prognostic marker in coronary artery disease (CAD). The extent to which coronary revascularization can improve CFR is unclear. This study aimed to evaluate the impact of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) on CFR in patients with stable CAD.
Methods And Results:
In a prospective, multicentre observational study, CFR was measured by 15O-water positron emission tomography as the ratio of stress to rest myocardial blood flow at baseline and 6 months after optimal medical therapy (OMT) alone, PCI, or CABG. Changes in the SYNTAX and Leaman scores were angiographically evaluated as indicators of completeness of revascularization. Follow-up was completed by 75 (25 OMT alone, 28 PCI, and 22 CABG) out of 82 patients. The median SYNTAX and Leaman scores, and baseline CFR were 14.5 [interquartile range (IQR): 8-24.5], 5.5 (IQR: 2.5-12.5), and 1.94 (IQR: 1.67-2.66), respectively. Baseline CFR was negatively correlated with the SYNTAX (ρ = -0.40, P < 0.001) and Leaman scores (ρ = -0.33, P = 0.004). Overall, only CABG was associated with a significant increase in CFR [1.67 (IQR: 1.14-1.96) vs. 1.98 (IQR: 1.60-2.39), P < 0.001]. Among patients with CFR <2.0 (n = 41), CFR significantly increased in the PCI [1.70 (IQR: 1.42-1.79) vs. 2.21 (IQR: 1.78-2.49), P = 0.002, P < 0.001 for interaction between time and CFR] and CABG groups [1.28 (IQR: 1.13-1.80) vs. 1.86 (IQR: 1.57-2.22), P < 0.001]. The reduction in SYNTAX or Leaman scores after PCI or CABG was independently associated with the percent increase in CFR after adjusting for baseline characteristics (P = 0.012 and P = 0.011, respectively).
Conclusion:
Coronary revascularization ameliorated reduced CFR in patients with obstructive CAD. The degree of improvement in angiographic CAD burden by revascularization was correlated with magnitude of improvement in CFR.
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease II: Pathophysiology
01:27Coronary Artery Disease V: Interprofessional Care
01:30Coronary Artery Disease III: Clinical Manifestations
01:26Coronary Artery Disease IV: Preventive Measures
01:21Coronary Circulation
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...