title: Noninvasive assessment of myocardial ischemia in the left ventricular inferior regions by coronary flow reserve measurement using transthoracic Doppler echocardiography.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the potential of noninvasive measurement of coronary flow reserve (CFR) by transthoracic Doppler echocardiography (TTDE) for the assessment of myocardial ischemia in the left ventricular (LV) inferior regions.
  
  
  BACKGROUND
  Although coronary flow assessment by TTDE has been determined for the assessment of perfusion abnormality in the LV anterior regions, the usefulness of this method has not been well investigated in the LV inferior regions.
  
  
  METHODS
  We studied 50 patients (43 men; mean age 60 +/- 9 years) with suggested coronary artery disease. CFR in the posterodescending coronary artery (PDA) was calculated as a ratio of hyperemic to basal peak (peak CFR) and mean (mean CFR) flow velocities in the PDA, which were measured by TTDE. CFR values were compared with the results of exercise 201-thallium single photon emission computed tomography.
  
  
  RESULTS
  CFR was successfully measured in 43 of 50 patients (86%). Mean and peak CFR < 2 were shown in 10 of 12 patients with abnormal perfusion in the LV inferior regions, whereas CFR > or = 2 were shown in 30 of 31 patients with normal perfusion. Thus, CFR < 2 in the PDA by TTDE had a sensitivity of 83% and a specificity of 97% for the assessment of perfusion abnormality in the LV inferior regions by 201-thallium single photon emission computed tomography.
  
  
  CONCLUSIONS
  CFR in the PDA measured by TTDE provides data equivalent to those obtained by 201-thallium single photon emission computed tomography for myocardial ischemia in the LV inferior regions.
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Medical School, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Tokai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Kumiko
authors.initials: K
authors.lastname: Hirata
authors.forename: Ryo
authors.initials: R
authors.lastname: Otsuka
authors.forename: Takashi
authors.initials: T
authors.lastname: Muro
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamagishi
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hozumi
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012039:Regional Blood Flow; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D013794:Thallium Radioisotopes