Transesophageal versus intracoronary Doppler measurements for calculation of coronary flow reserve.
OBJECTIVE
The present study was performed to compare coronary flow reserve by transesophageal Doppler echocardiography and intracoronary Doppler flow wire measurements in patients with LAD disease.


METHODS
17 patients with various degree of LAD stenosis were studied. Intracoronary LAD Doppler measurements were performed at baseline and after intracoronary injection of 18 micrograms adenosine. Transesophageal coronary sinus and LAD Doppler measurements were performed at baseline and after intravenous dipyridamole (0.6 mg/kg/5 min). Coronary flow reserve was calculated as the ratio of hyperemic to baseline average peak velocities.


RESULTS
Coronary flow reserve was 2.44 +/- 0.62 and 2.19 +/- 0.76 for proximal and distal intracoronary measurements and was 2.25 +/- 0.64 and 1.74 +/- 0.63 for transesophageal LAD- and coronary sinus measurements. Proximal intracoronary flow reserve significantly correlated with transesophageal coronary sinus (r = 0.73, p < or = 0.001) and LAD (r = 0.70, p < or = 0.005) measurements, whereas distal intracoronary flow reserve only correlated with transesophageal coronary sinus flow reserve (r = 0.56, p < or = 0.02). Receiver operating characteristic curve analysis demonstrated similar diagnostic accuracy of all applied techniques for detection of a significant LAD stenosis.


CONCLUSIONS
Coronary flow reserve by both transesophageal techniques correlated with intracoronary Doppler flow wire measurements, however considerable discrepancies may occur in the individual patient.
Zehetgruber
M
M
Department of Cardiology, University of Vienna, Austria.
Porenta
G
G
Mundigler
G
G
Mörtl
D
D
Binder
T
T
Christ
G
G
Probst
P
P
Baumgartner
H
H
Maurer
G
G
Siostrzonek
P
P
D000241:Adenosine / Q000008:administration & dosage; D002317:Cardiovascular Agents / Q000008:administration & dosage; D017023:Coronary Angiography; D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004176:Dipyridamole / Q000008:administration & dosage; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional; D014665:Vasodilator Agents / Q000008:administration & dosage
D002317:Cardiovascular Agents; D014665:Vasodilator Agents; D004176:Dipyridamole; D000241:Adenosine