Assessment of myocardial perfusion by harmonic power doppler imaging at rest and during adenosine triphosphate stress: comparison with coronary flow velocity reserve in the left anterior descending coronary arter.
To clarify whether the myocardial perfusion abnormalities observed on harmonic power Doppler imaging (HPDI) during hyperemia are related to a decrease in coronary flow velocity reserve (CFVR), HPDI and CFVR were measured in the left anterior descending coronary artery (LAD) territory of 75 patients. During continuous infusion of Levovist, dual-frame triggered apical 4-chamber views were obtained at rest and during adenosine triphosphate (ATP) infusion. The persistence of perfusion defects during ATP infusion or stress-induced defects in the LAD territory was defined as abnormal. Both HPDI and coronary flow velocity recordings of adequate quality were successfully obtained in 73 patients, and 37 patients showed abnormal myocardial perfusion. CFVR was significantly lower in patients with abnormal perfusion than in patients who had normal findings (1.38+/-0.38 vs 2.60+/-0.76, p<0.001). A CFVR less than 1.9 had a sensitivity of 89% (33/37) and a specificity of 89% (32/36) for predicting the presence of abnormal myocardial perfusion. This study demonstrates that myocardial perfusion abnormalities observed during HPDI using ATP stress are closely correlated to a decrease in CFVR and may reflect significant stenosis or microvascular damage in the LAD territory.
Takeuchi
Masaaki
M
Department of Internal Medicine, Tane General Hospital, Graduate School of Medicine, Osaka City University, Osaka, Japan. masaaki_takeuchi@hotmail.com
Yoshitani
Hidetoshi
H
Miyazaki
Chinami
C
Otani
Shinichiro
S
Sakamoto
Kazuo
K
Yoshikawa
Junichi
J
D000255:Adenosine Triphosphate; D015906:Angioplasty, Balloon, Coronary; D001783:Blood Flow Velocity; D003326:Coronary Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006321:Heart / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012146:Rest
D000255:Adenosine Triphosphate