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INVASIVE AND INTERVENTIONAL CARDIOLOGY

Coronary flow velocity reserve does not correlate with TIMI frame count in patients undergoing non-emergency percutaneous coronary intervention

Sanjay K. Chugh, MD^*, Jennifer Koppel, BSc^*, Mark Scott, BSc^*, Lana Shewchuk, BN^*, David Goodhart, MD^*, Raoul Bonan, MD, Jean-Claude Tardif, MD, Stephen G. Worthley, MBBS, PhD, Carlo DiMario, MD, Michael J. Curtis, MD^*, Ian T. Meredith, MBBS, PhD and Todd J. Anderson, MD^*,*

^* Department of Cardiovascular Sciences, University of Calgary, Calgary, Canada
Montreal Heart Institute, Montreal, Canada
Monash Medical Centre, Monash University, Melbourne, Australia
Milan, Italy

Manuscript received September 9, 2003; revised manuscript received May 4, 2004, accepted May 11, 2004.

^* Reprint requests and correspondence: Dr. Todd J. Anderson, Division of Cardiology, Foothills Hospital, 1432, 29th Street, NW, Calgary, AB, T2N 2T9, Canada (Email: todd.anderson{at}calgaryhealthregion.ca).

OBJECTIVES: The purpose of this research was to compare the Thrombolysis In Myocardial Infarction (TIMI) frame count (CTFC) with coronary flow velocity reserve (CFVR) in patients undergoing percutaneous coronary intervention (PCI).

BACKGROUND: The relationship between CTFC and CFVR has not been adequately assessed in patients with coronary artery disease.

METHODS: We studied 62 patients who underwent successful non-emergent PCI. All patients had Doppler evaluation of CFVR, CTFC, and quantitative coronary angiography. In an additional 17 patients, a frame count reserve was calculated as baseline CTFC/CTFC at peak hyperemia, induced by intracoronary adenosine after PCI.

RESULTS: The CTFC decreased from 27 ± 13 to 18 ± 8, and CFVR increased from 1.5 ± 0.4 to 2.6 ± 0.7 (both p < 0.0001). The pre-PCI CTFC and the CFVR were closely related to minimal lumen diameter (p < 0.0001). After PCI, there was no correlation between CFVR and CTFC. In addition, no relationship was observed between CFVR and the frame count reserve.

CONCLUSIONS: There was no significant correlation between CFVR and CTFC in patients undergoing coronary intervention. The relative utility of these measures in predicting outcomes in this setting requires further evaluation, but CTFC (or frame count reserve) does not appear to be an adequate surrogate measure of Doppler-derived CFVR.

Abbreviations and Acronyms   APV = average peak velocity   CFVR = coronary flow velocity reserve   CTFC = corrected TIMI frame count   DESTINI = Doppler Endpoint Stenting International Investigation   LV = left ventricle/ventricular   MI = myocardial infarction   MLD = minimal lumen diameter   PCI = percutaneous coronary intervention   TIMI = Thrombolysis In Myocardial Infarction

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