title: [Detection of angiographic lesions in the left anterior descending coronary artery by transthoracic Doppler echocardiography: usefulness of non-invasive assessment of coronary flow reserve].
abstract: 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.
authors.affiliation: Servicio de Cardiología. Hospital Universitario Virgen de la Arrixaca. Murcia. España.
authors.forename: Rafael
authors.initials: R
authors.lastname: Florenciano Sánchez
authors.forename: Gonzalo de
authors.initials: Gd
authors.lastname: La Morena Valenzuela Gd
authors.forename: Federico
authors.initials: F
authors.lastname: Soria Arcos
authors.forename: Ramón
authors.initials: R
authors.lastname: Rubio Patón
authors.forename: Ramón
authors.initials: R
authors.lastname: López Palop
authors.forename: Manuel
authors.initials: M
authors.lastname: Villegas García
authors.forename: Eduardo
authors.initials: E
authors.lastname: Pinar Bermúdez
authors.forename: Mariano
authors.initials: M
authors.lastname: Valdés Chávarri
mesh_terms: 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
chemical_list: D003287:Contrast Media