Coronary flow velocity at rest: a speed limit for a safe prognostic journey?

Abstract

The study presented by Zagatina and co-workers in the present issue of the Journal raises an interesting issue. Coronary flow velocity at rest is usually associated with dynamic assessment during stress but it may also have an important pathophysiologic and prognostic meaning when evaluated at rest, before stress. This is new, apparently surprising and counterintuitive. However, at a closer look it fits well with the pathophysiological background and initial preliminary clinical experience available in this important but still largely unexplored field.

Keywords:

• Coronary flow velocity reserve
• rest
• transthoracic echocardiography

Disclosure statement

No potential conflict of interest was reported by the author(s).

Figure 1. Resting flow and flow reserve. Even with normal coronary arteries and preserved maximal vasodilatory capacity, coronary flow reserve (a recognised biomarker of poor prognosis) can be reduced for increased resting flow, present when one or more determinants of resting myocardial oxygen consumption are increased or when myocardial oxygen supply decreases for anaemia or hypoxia.