Assessment of coronary flow reserve with transthoracic Doppler echocardiography: comparison with intracoronary Doppler method.
To evaluate the feasibility and usefulness of transthoracic Doppler echocardiography (TTDE) as a non-invasive method in recording distal anterior descending (LAD) coronary flow velocity, we compared coronary flow reserve (CFR) measured by TTDE with measurements by intracoronary Doppler wire (ICDW). Twenty-one patients without LAD stenosis were studied. ICDW performed at baseline and after intracoronary injection of 18 microg adenosine. TTDE was performed at baseline and after intravenous adenosine (140 microg/kgmin for 2 min). Adequate Doppler recordings of coronary flow velocities during systole were obtained in 14 of 21 study patients (67%) and during diastole in 17 (81%) patients. Baseline and hyperemic peak diastolic flow velocities measured by TTDE were significantly smaller than those obtained by ICDW (p<0.05). However, diminishing trends of diastolic and systolic velocity ratio after hyperemia were similarly observed in both methods. CFR obtained by TTDE (3.0+/-0.5), was higher than the value calculated by ICDW (2.5+/-0.4). There were significant correlations between the values obtained by the two methods (r=0.72, p<0.01). It is concluded that TTDE is a feasible method in measuring coronary flow velocity and appears to be a promising non-invasive method in evaluating CFR.
Kim
S M
SM
Department of Internal Medicine, Korea University College of Medicine, Seoul.
Shim
W J
WJ
Lim
H E
HE
Hwang
G S
GS
Song
W H
WH
Lim
D S
DS
Kim
Y H
YH
Seo
H S
HS
Oh
D J
DJ
Ro
Y M
YM
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D017023:Coronary Angiography; D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D015150:Echocardiography, Doppler / Q000379:methods* / Q000592:standards; D005260:Female; D006339:Heart Rate; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results