the diagnostic value of left-anterior-descending artery velocity assessed by transthoracic Doppler echocardiography for microvascular dysfunction in stenotic left-anterior-descending artery

Abstract Background Index of microcirculatory resistance (IMR) has been used as a clinical measure microvascular function. Transthoracic Doppler echocardiography (TDE) can provide information on the functional status coronary artery circulation. This study aims to assess diagnostic value left-anterior-descending (LAD) flow velocity by TDE for dysfunction. Methods Consecutive patients who were scheduled elective percutaneous intervention (PCI) LAD lesions prospectively enrolled in single tertiary-care center between April 2020 and July 2021. Pre-PCI diastolic peak (DPV) at rest hyperemia measured. By invasive angiography, quantitative angiography wire-based physiological indices including fractional reserve (FFR) index Results A total 104 studied. Median FFR IMR values 0.70 (0.60–0.74) 20.68 (14.92–31.69), respectively. No significant relationship was observed IMR. The prevalence dysfunction defined IMR≥25 39.4%. Basal DPV 25 (20–33) cm/sec, hyperemic 51 (41–67) cm/sec. In with IMR≥25, reference diameter (RD) significantly greater [2.63 (2.22–3.19) mm vs 2.39 (2.09–2.66) mm, p=0.019], basal lower [26 (18–29) cm/sec 29 (22–37) p=0.022)] [49 (19–54) 56 (42–70) p=0.023] compared IMR<25. ROC analysis showed RD are predictors [basal DPV: AUC 0.633 (0.525–0.742), best cutoff 29cm/sec RD: 0.636 (0.523–0.750), 2.84mm]. Multivariable logistic regression DPV<29cm/sec RD>2.84mm independent [Odds ratio: 3.08 (1.22–7.78), p=0.017; odds ratio 4.40 (1.55–12.50), p=0.005]. Conclusion non-invasive pre-PCI predict coexisting territory functionally without need vasodilator-induced measurement. Funding Acknowledgement Type funding sources: None.