[Detection of angiographic lesions in the left anterior descending coronary artery by transthoracic Doppler echocardiography: usefulness of non-invasive assessment of coronary flow reserve].
BACKGROUND
We evaluated the feasibility of detecting blood flow in the left anterior descending coronary artery and the usefulness of measuring coronary flow reserve to diagnose significant coronary artery disease, both by means of transthoracic Doppler echocardiography using a high-frequency transducer and echo-contrast agent.


METHODS
We studied 107 patients who were scheduled for coronary arteriography for known or suspected ischemic heart disease. A Doppler signal was recorded by a pulsed wave in the distal left anterior descending artery at baseline and after dipyridamole infusion. An echo-contrast agent was administered to all patients. A coronary flow reserve equal to or higher than 1.7 was considered normal.


RESULTS
We recorded Doppler signals in the left anterior descending coronary artery of 83 patients (78%). Significant stenosis of the left anterior descending coronary artery was observed in 24 out of 83 patients (29%). The prevalence of significant stenosis was higher (62 vs 29%; p = 0.006) in patients in which no Doppler signal was detected. The sensitivity, specificity, and accuracy of abnormal coronary flow reserve in detecting significant stenosis of the left anterior descending coronary artery were 87, 74 and 78%, respectively.


CONCLUSIONS
The measurement of coronary flow reserve by transthoracic Doppler echocardiography using a high-frequency transducer and echo-contrast agent is a feasible, widely available, and accurate method for detecting significant stenosis of the left anterior descending coronary artery.
Florenciano Sánchez
Rafael
R
Servicio de Cardiología. Hospital Universitario Virgen de la Arrixaca. Murcia. España.
La Morena Valenzuela Gd
Gonzalo de
Gd
Soria Arcos
Federico
F
Rubio Patón
Ramón
R
López Palop
Ramón
R
Villegas García
Manuel
M
Pinar Bermúdez
Eduardo
E
Valdés Chávarri
Mariano
M
D000368:Aged; D003287:Contrast Media; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation
D003287:Contrast Media