Correlation of Non-Invasive Transthoracic Doppler Echocardiography with Invasive Doppler Wire-Derived Coronary Flow...

Area of Science:

• Cardiology
• Vascular Biology
• Diagnostic Imaging

Background:

• Coronary microvascular dysfunction is linked to poor outcomes post-ST-elevation myocardial infarction (STEMI).
• Accurate assessment of coronary flow reserve (CFR) is crucial for predicting prognosis.
• Comparing invasive and non-invasive CFR methods is important for clinical application.

Purpose of the Study:

• To compare invasive Doppler wire-based CFR with non-invasive transthoracic Doppler echocardiography (TTDE)-derived CFR.
• To evaluate the predictive ability of both CFR methods for final infarct size after STEMI.

Main Methods:

• 36 STEMI patients undergoing primary PCI had invasive Doppler wire CFR assessed.
• TTDE-derived CFR was measured in 47 vessels (29 patients) within 6 hours of invasive assessment.
• Infarct size was quantified using cardiac magnetic resonance (CMR) at 8 months.

Main Results:

• A modest correlation was observed between invasive and TTDE-derived CFR overall (rho=0.400, p=0.005).
• Correlation improved significantly for LAD artery measurements (rho=0.554, p=0.002) but not RCA.
• Both invasive and TTDE-derived CFR effectively predicted large infarct size (≥18% LV mass) with AUCs of 0.888 and 0.868, respectively.

Conclusions:

• TTDE-derived CFR shows significant correlation with invasive Doppler wire CFR in the LAD artery post-STEMI.
• Both invasive and non-invasive CFR methods demonstrate comparable strong associations with final infarct size.
• These findings support the potential utility of non-invasive TTDE for assessing microvascular function and predicting infarct size in STEMI.