title: Transthoracic Doppler echocardiography as a noninvasive tool to assess coronary artery stenoses--a comparison with quantitative coronary angiography.
abstract: We prospectively tested the diagnostic accuracy of Doppler transthoracic echocardiography in detection of coronary artery stenoses throughout the main coronary arterial tree. In all, 84 patients referred for diagnostic quantitative coronary angiography were studied. Coronary artery stenosis was identified with color Doppler as local spot of turbulence, and local flow velocity was measured using pulsed wave Doppler. Angiography showed significant stenoses (diameter reduction > 50%) in 33 patients. An abnormal maximal-to-prestenotic blood flow velocity ratio greater than 2.0 in subtotal stenoses, or the detection of collateral blood flow in the absence of normal antegrade flow in the case of total occlusion (N = 6), resulted in overall sensitivity of 82% and specificity of 92%. The sensitivity and specificity were, respectively, 73% and 92% for left anterior descending coronary artery, 63% and 96% for right coronary artery, and 38% and 99% for left circumflex coronary artery stenoses. Transthoracic echocardiography is a promising noninvasive technique to diagnose significant coronary artery stenoses.
authors.affiliation: Department of Clinical Physiology, Turku University Hospital, Turku, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Saraste
authors.forename: Risto K
authors.initials: RK
authors.lastname: Vesalainen
authors.forename: Antti
authors.initials: A
authors.lastname: Ylitalo
authors.forename: Antti
authors.initials: A
authors.lastname: Saraste
authors.forename: Juha W
authors.initials: JW
authors.lastname: Koskenvuo
authors.forename: Jyri O
authors.initials: JO
authors.lastname: Toikka
authors.forename: Mari-Anne
authors.initials: MA
authors.lastname: Vaittinen
authors.forename: Jaakko J
authors.initials: JJ
authors.lastname: Hartiala
authors.forename: K E Juhani
authors.initials: KE
authors.lastname: Airaksinen
mesh_terms: D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity