Improved systolic function after PTCA can be estimated by femoral arterial Doppler.
The effect of coronary angioplasty to the post exertional femoral arterial pulse was analyzed in a prospective trial. In 26 patients 30 coronary stenoses could be treated. Narrowed lumen diameter dropped from 85.5% +/-8.2 to 34.6% +/-10.7 (P<0.0001). Patients with a residual coronary artery stenosis of <60% (group A, n=15) were compared to those with incomplete revascularisation (stenoses >60%, group B, n=11). Post exertional Doppler criteria differed between both groups: Peak velocity in group A was 86.08 cm/s +/- 17.8, in group B 72.9 cm/s +/-17, mean velocity 32.06 cm/s +/-12.5 versus 23.6 cm/s +/-10.3 acceleration or dV/dt 813.5 cm/s2 versus 722 cm/s2 +/-164. Statistical significant pre to post postexertional findings improved only in group A (P<0.01, peak velocity, P<0.05 mean velocity and dV/dt). It is concluded that patients with still-existing exertional myocardial ischemia can be distinguished from those without hemodynamic relevant stenoses by means of a simple noninvasive Doppler analysis of femoral arterial pulse.
Cieslinski
G
G
Medical Department of Northwest Hospital, Frankfurt/Main, Germany.
Schräder
R
R
Sievert
H
H
D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000628:therapy*; D015150:Echocardiography, Doppler; D005080:Exercise Test; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011674:Pulse; D012680:Sensitivity and Specificity; D013599:Systole