Authors

• Alden Begić — Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0002-5374-0892
• Edin Begić — General Hospital “Prim.dr. Abdulah Nakaš”, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0001-6842-262X
• Nirvana Šabanović-Bajramović — Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0003-3749-6073
• Amer Iglica — Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0002-4677-8489
• Nermir Granov — Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0002-6228-6230
• Mirza Dilić — Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0002-7309-1455
• Zijo Begić — Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0002-1863-5755

Keywords

echocardiography, atherosclerosis, prevention

DOI

Full Text

**Goal:** To indicate the influence of risk factors for the development of coronary artery disease (CAD) on coronary flow reserve (CFR) values assessed by transthoracic echocardiography (TTE) ​​in patients without verified CAD. **Methods:** The paper presents an analysis of the available literature from reference databases covering the mentioned topic. **Results:** TTE-CFR presents a ratio of hyperaemic coronary blood flow during maximum vasodilation in relation to resting coronary blood flow. The most commonly used vasodilators are dipyridamole and adenosine (adenosine 140 mcg⁄kg⁄min (1-2 min), dipyridamole 0.84 mg⁄kg⁄6 min). Age and female gender have a lesser effect on the values of hyperemic CFR. Ethnic differences (vascularization, left ventricle structure) can influence the CFR values. Also, obesity, smoking, hyperlipidemia, elevated values ​​of low-density lipoproteins (LDL), arterial hypertension, diabetes mellitus, and obstructive sleep apnea in a healthy population can have a negative effect on CFR values. **Conclusion:** There is evidence of the effect of risk factors for CAD on CFR values ​​in a population without established pathology. (1-3) It is a marker of the early stages of coronary atherosclerosis (a tool in the stratification of patients regarding cardiovascular risk, and it could be a guide in the primary prevention of cardiovascular disease). Also, TTE-CFR<2 has good sensitivity and specificity to predict the significance of stenosis. Clinical presentation of the patient should be a part of the mosaic of interpretation of test results. CFR is an additional test, and stress echocardiography presents the first choice in the evaluation of ischemic heart disease.

Literature

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