Analysis of coronary flow reserve using Doppler guide wire in patients with chronic renal replacement therapy

To investigate the coronary blood flow dynamics in dialysis patients, we measured the coronary blood flow velocity and coronary flow reserve using Doppler guide wire. We studied 7 dialysis patients who had no significant coronary artery stenosis, but were suspected of ischemic heart disease due to their clinical symptoms and electrocardiographic findings. Mean age was 58 years old and mean duration of dialysis was 94 months. Eight non-uremic sujects who had no significant coronary artery stenosis served as controls.Using Doppler guide wire in the proximal left anterior descending artery, we analyzed the average peak velocity (APV), maximum peak velocity (MPV), and diastolic/systolic velocity ratio (DSVR) at baseline and a hyperemic stage. Coronary flow reserve was assessed by the ratio of flow velocity change induced by papaverine hydroclorie (10mg).The APV and MPV at the baseline of dialysis patients were significantly higher than those of the control patients. The coronary flow reserve of dialysis patients (2.3±0.7) was lower than that of the control patients (3.9±0.6).In conclusion, coronary flow reserve of dialysis patients was lower than that of the control patients due to high APV.