New noninvasive diagnosis of myocardial ischemia of the left circumflex coronary artery using coronary flow reserve measurement by transthoracic Doppler echocardiography: comparison with thallium-201 single photon emission computed tomography.
OBJECTIVE
The usefulness of coronary flow reserve measurement in the left circumflex coronary artery by transthoracic Doppler echocardiography to detect myocardial ischemia was compared with exercise thallium-201 single photon emission computed tomography (SPECT).


METHODS
Transthoracic Doppler echocardiography was performed in 110 patients with suspected coronary artery disease. Color Doppler signals of the left circumflex coronary artery flow in the apical four-chamber view were identified, and the velocities at rest and during hyperemia recorded for calculation of coronary flow reserve by the pulsed Doppler method. All patients underwent SPECT within 1 week of the transthoracic Doppler echocardiographic study.


RESULTS
Coronary flow reserve in the left circumflex coronary artery was measured in 79 (72%) of 110 patients. SPECT revealed reversible perfusion defect in the left circumflex coronary artery territories in 12 of 69 patients excluding those with multivessel disease. Coronary flow reserve < 2.0 had a sensitivity of 92% and specificity of 96% for reversible perfusion defect detected by SPECT.


CONCLUSIONS
Noninvasive coronary flow reserve measurement in the left circumflex coronary artery by transthoracic Doppler echocardiography can estimate myocardial ischemia in the left ventricular lateral regions.
Fujimoto
Kohei
K
Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Asahimachi 1-4-3, Abeno-ku, Osaka 545-8585.
Watanabe
Hiroyuki
H
Hozumi
Takeshi
T
Otsuka
Ryo
R
Hirata
Kumiko
K
Yamagishi
Hiroyuki
H
Yoshiyama
Minoru
M
Yoshikawa
Junichi
J
D000368:Aged; D001783:Blood Flow Velocity; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods*; D015150:Echocardiography, Doppler / Q000379:methods*; D005080:Exercise Test; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D015588:Observer Variation; D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes