title: Validation of transesophageal echocardiography to determine physiologic coronary flow.
abstract: Human studies have suggested that Doppler transesophageal echocardiography (TEE) can determine normal physiologic coronary blood flow (CBF) and alterations in CBF due to proximal flow-limiting stenoses. However, assessment of CBF by Doppler TEE has not been validated. To determine if true estimation of CBF could be obtained with Doppler TEE, seven mongrel dogs (weight range 28 kg-36 kg) were evaluated. Simultaneous CBF determinations by Doppler TEE and epicardial electromagnetic flow (EMF) and/or epicardial Doppler flow (EDF) probes were compared. Measurements were obtained at baseline and following varying degrees of proximal coronary occlusion, which produced reactive hyperemia.
  
  
  RESULTS
  Consistent Doppler flow waveforms were obtainable by Doppler TEE in 34 different measurements during perturbations: Mean for TEE Flow (ml/min) = 85, EMF or EDF Flow (ml/min) = 53; Standard Deviation for TEE Flow (ml/min) = 45, EMF or EDF Flow (ml/min) = 38; Minimum for TEE Flow (ml/min) = 42, EMF or EDF Flow (ml/min) = 11; and Maximum for TEE Flow (ml/min) = 174, EMF or EDF Flow (ml/min) = 130. TEE Flow (ml/min) = 1.1 EMF/EDF flow + 26.3. There was a general trend towards overestimation of CBF by Doppler TEE. This study demonstrates that Doppler TEE is a promising method for obtaining measurements of CBF over the physiologic range.
authors.affiliation: Columbia University, College of Physicians and Surgeons, Division of Cardiology, St. Luke's-Roosevelt Hospital Center, 1111 Amsterdam Avenue, New York, NY 10025, USA. fchaudhry@slrhc.org
authors.forename: F A
authors.initials: FA
authors.lastname: Chaudhry
authors.forename: J F
authors.initials: JF
authors.lastname: Ren
authors.forename: K
authors.initials: K
authors.lastname: Ramani
authors.forename: A S
authors.initials: AS
authors.lastname: Yaacoub
authors.forename: B J
authors.initials: BJ
authors.lastname: Kane
authors.forename: R
authors.initials: R
authors.lastname: Greene
authors.forename: D D
authors.initials: DD
authors.lastname: McPherson
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity; D016001:Confidence Intervals; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004285:Dogs; D017548:Echocardiography, Transesophageal / Q000379:methods*; D016014:Linear Models; D023421:Models, Animal; D011336:Probability; D012016:Reference Values; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods