title: Coronary flow velocity reserve measurement in three major coronary arteries using transthoracic Doppler echocardiography.
abstract: BACKGROUND
  Measurement of the coronary flow velocity reserve (CFVR) by transthoracic Doppler echocardiography (TTDE) has been reported to be useful for the noninvasive assessment of significant coronary artery stenosis or myocardial ischemia. The purpose of this study was to evaluate the value of this method in three major coronary arteries for detecting myocardial ischemia in the clinical setting.
  
  
  METHODS
  We studied 89 consecutive patients who were referred to our outpatient clinic because of chest pain. We measured CFVR using TTDE in three major coronary arteries. We defined CFVR<2.0 in at least one vessel as being positive for myocardial ischemia. The accuracy of CFVR measurements for detecting myocardial ischemia was determined in comparison with exercise thallium-201 (Tl-201) single photon emission computed tomography (SPECT) as a reference standard.
  
  
  RESULTS
  CFVR in at least one vessel was successfully measured in 87 of 89 patients (98%). The sensitivity and specificity of CFVR<2.0 in at least one coronary vessel, in any of the coronary territories, was 86% and 89%, respectively. In terms of assessing myocardial ischemia in each coronary artery territory, the agreement between CFVR<2.0 and Tl-201 SPECT for the left anterior descending coronary artery, the posterior descending coronary artery, and the left circumflex coronary artery territories was 95%, 81%, and 73%, respectively.
  
  
  CONCLUSIONS
  Noninvasive CFVR measurement by TTDE may be useful for detecting myocardial ischemia, as well as for identifying ischemic territories in the clinical setting.
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Medical School, Osaka, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Murata
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hozumi
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Matsumura
authors.forename: Kohei
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sugioka
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Takemoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamagishi
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwao
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
mesh_terms: D000255:Adenosine Triphosphate / Q000008:administration & dosage; D000368:Aged; D001783:Blood Flow Velocity; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018618:Echocardiography, Doppler, Color; D005080:Exercise Test; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging*; D008297:Male; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D013794:Thallium Radioisotopes; D000255:Adenosine Triphosphate