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Normal coronary flow reserve after arterial switch operation for transposition of the great arteries: an intracoronary Doppler guidewire study.

Oskarsson, Gylfi; Pesonen, Erkki LU ; Munkhammar, Peter LU ; Sandström, Staffan LU and Jögi, Peeter LU (2002) In Circulation 106(13). p.1696-1702
Abstract
BACKGROUND: Recent studies performed with positron emission tomography have suggested that coronary flow reserve (CFR) is moderately to severely reduced after the arterial switch operation (ASO). These findings are of great concern but have not been confirmed by other methods. METHODS AND RESULTS: Eleven symptom-free children were studied between 4 and 11 (median 6.0) years after the ASO. Flow velocity in the left anterior descending (LAD) and right coronary arteries (RCA) was measured with a 0.014-inch Doppler FloWire (Cardiometrics) before and after intracoronary injection of adenosine (0.5 micro g/kg) and nitroglycerin (5 micro g/kg). CFR was defined as the ratio of hyperemic to basal average peak velocity (APV). The median (range) CFR... (More)
BACKGROUND: Recent studies performed with positron emission tomography have suggested that coronary flow reserve (CFR) is moderately to severely reduced after the arterial switch operation (ASO). These findings are of great concern but have not been confirmed by other methods. METHODS AND RESULTS: Eleven symptom-free children were studied between 4 and 11 (median 6.0) years after the ASO. Flow velocity in the left anterior descending (LAD) and right coronary arteries (RCA) was measured with a 0.014-inch Doppler FloWire (Cardiometrics) before and after intracoronary injection of adenosine (0.5 micro g/kg) and nitroglycerin (5 micro g/kg). CFR was defined as the ratio of hyperemic to basal average peak velocity (APV). The median (range) CFR in the LAD was 3.7 (3.0 to 4.8) and 3.4 (2.9 to 4.8) in the RCA. The increase in APV after intracoronary injection of nitroglycerin was 300% (240% to 420%) in the LAD and 260% (190% to 460%) in the RCA. APV at rest was 15.0 (14.0 to 21.0) cm/s in the LAD and 16.0 (9.6 to 30.0) cm/s in the RCA. A linear relation was found between right ventricular systolic pressure and resting APV in the RCA (r=0.77, P=0.0056), and between resting APV and CFR (r=-0.61, P<0.05) in the RCA. CONCLUSIONS: The CFR and coronary vasoreactivity to nitroglycerin in children treated for transposition of the great arteries with the ASO was within normal limits. Increased right ventricular pressure and myocardial hypertrophy can cause increased resting coronary flow velocity in the RCA and affect CFR negatively. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Circulation
volume
106
issue
13
pages
1696 - 1702
publisher
Lippincott Williams and Wilkins
external identifiers
  • pmid:12270865
  • wos:000178311500031
  • scopus:0037167695
ISSN
1524-4539
DOI
10.1161/01.CIR.0000030937.27602.BD
language
English
LU publication?
yes
id
10daefda-bd8b-4a3d-90ac-f9fadb16f986 (old id 110201)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12270865&dopt=Abstract
date added to LUP
2007-07-19 13:25:45
date last changed
2017-11-05 04:25:49
@article{10daefda-bd8b-4a3d-90ac-f9fadb16f986,
  abstract     = {BACKGROUND: Recent studies performed with positron emission tomography have suggested that coronary flow reserve (CFR) is moderately to severely reduced after the arterial switch operation (ASO). These findings are of great concern but have not been confirmed by other methods. METHODS AND RESULTS: Eleven symptom-free children were studied between 4 and 11 (median 6.0) years after the ASO. Flow velocity in the left anterior descending (LAD) and right coronary arteries (RCA) was measured with a 0.014-inch Doppler FloWire (Cardiometrics) before and after intracoronary injection of adenosine (0.5 micro g/kg) and nitroglycerin (5 micro g/kg). CFR was defined as the ratio of hyperemic to basal average peak velocity (APV). The median (range) CFR in the LAD was 3.7 (3.0 to 4.8) and 3.4 (2.9 to 4.8) in the RCA. The increase in APV after intracoronary injection of nitroglycerin was 300% (240% to 420%) in the LAD and 260% (190% to 460%) in the RCA. APV at rest was 15.0 (14.0 to 21.0) cm/s in the LAD and 16.0 (9.6 to 30.0) cm/s in the RCA. A linear relation was found between right ventricular systolic pressure and resting APV in the RCA (r=0.77, P=0.0056), and between resting APV and CFR (r=-0.61, P&lt;0.05) in the RCA. CONCLUSIONS: The CFR and coronary vasoreactivity to nitroglycerin in children treated for transposition of the great arteries with the ASO was within normal limits. Increased right ventricular pressure and myocardial hypertrophy can cause increased resting coronary flow velocity in the RCA and affect CFR negatively.},
  author       = {Oskarsson, Gylfi and Pesonen, Erkki and Munkhammar, Peter and Sandström, Staffan and Jögi, Peeter},
  issn         = {1524-4539},
  language     = {eng},
  number       = {13},
  pages        = {1696--1702},
  publisher    = {Lippincott Williams and Wilkins},
  series       = {Circulation},
  title        = {Normal coronary flow reserve after arterial switch operation for transposition of the great arteries: an intracoronary Doppler guidewire study.},
  url          = {http://dx.doi.org/10.1161/01.CIR.0000030937.27602.BD},
  volume       = {106},
  year         = {2002},
}