Noninvasive assessment of coronary flow velocity reserve in left anterior descending artery adds diagnostic value to both clinical variables and dobutamine echocardiography: a study based on clinical practice.
OBJECTIVE
Our objective was to evaluate, in clinical practice, whether noninvasive assessment of coronary flow velocity reserve in left anterior coronary artery adds diagnostic information to both clinical variables and wall motion abnormalities derived from dobutamine stress echocardiography.


RESULTS
We studied 130 patients who were scheduled for coronary angiography after undergoing dobutamine stress echocardiography. The same day, flow in left anterior descending artery was detected by transthoracic Doppler echocardiography. A Doppler signal of left anterior descending artery was detected in 110 patients (85%). We identified significant left anterior descending artery stenosis (>50% diameter stenosis) in 42 patients. Sensitivity and specificity of abnormal coronary flow velocity reserve (<2) to detect left anterior descending artery stenosis were 86% and 57%, respectively. Wall motion abnormalities had a sensitivity and specificity of 52% and 82%. After forcing the clinical and dobutamine stress echo variables into a regression model with three modeling steps, an abnormal coronary flow velocity reserve provided incremental information in predicting significant left anterior descending artery stenosis.


CONCLUSIONS
An abnormal coronary flow velocity reserve by transthoracic Doppler echocardiography adds diagnostic value to both clinical data and variables derived from dobutamine stress echo to detect significant left anterior descending artery stenosis.
Hospital Universitario Virgen de la Arrixaca, Ctra. Madrid-Cartagena, 30120 El Palmar, Murcia, Spain. r_florenciano@hotmail.com
Rafael
R
Florenciano-Sánchez
Gonzalo
G
de la Morena-Valenzuela
Manuel
M
Villegas-García
Federico
F
Soria-Arcos
Ramón
R
Rubio-Patón
Francisca
F
Teruel-Carrillo
José
J
Hurtado
Mariano
M
Valdés-Chávarri
D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D004280:Dobutamine; D015150:Echocardiography, Doppler; D025401:Echocardiography, Stress; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016277:Ventricular Function, Left
D004280:Dobutamine