Testing coronary flow reserve without a provocative stress

Coronary flow reserve during dobutamine stress in Takotsubo stress cardiomyopathy

OBJECTIVES Takotsubo stress cardiomyopathy (TSC) is an increasingly recognised and diagnosed disease, although the underlying pathophysiology is still unknown. Our aim was to investigate the effect of the catecholamine dobutamine on coronary flow reserve (CFR) measured non-invasively in patients with TSC and controls. Our hypothesis was that dobutamine stress can induce microvascular dysfunctio...

Provocative testing for coronary reactivity and spasm.

Coronary spasm is an important and often overlooked etiology of chest pain. Although coronary spasm, or Prinzmetal's angina, has been thought of as benign, contemporary studies have shown serious associated adverse outcomes, including acute coronary syndrome, arrhythmia, and death. Definitive diagnosis of coronary spasm can at times be difficult, given the transience of symptoms. Numerous agent...

Coronary flow reserve.

Coronary Flow Velocity Reserve during Dobutamine Stress Echocardiography

BACKGROUND A coronary flow velocity reserve (CFVR)≥2 is adequate to infer a favorable prognosis or the absence of significant coronary artery disease. OBJECTIVE To identify parameters which are relevant to obtain CFVR (adequate or inadequate) in the left anterior descending coronary artery (LAD) during dobutamine stress echocardiography (DSE). METHODS 100 patients referred for detection of ...

A renaissance of provocative testing for coronary spasm?

The term variant angina, first used by Prinzmetal et al. (1) in 1959, denotes chest discomfort with classic features of angina but occurring at rest or at night (usually the early morning hours) rather than with exertional or emotional stress. The pain is often associated with ST segment elevation and is relieved by nitroglycerin. A female predominance and frequent association with cigarette sm...