Coronary flow velocity reserve measurement in three major coronary arteries using transthoracic Doppler echocardiography.
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.
Murata
Eriko
E
Department of Internal Medicine and Cardiology, Osaka City University Medical School, Osaka, Japan.
Hozumi
Takeshi
T
Matsumura
Yoshiki
Y
Fujimoto
Kohei
K
Sugioka
Kenichi
K
Takemoto
Yasuhiko
Y
Watanabe
Hiroyuki
H
Yamagishi
Hiroyuki
H
Yoshiyama
Minoru
M
Iwao
Hiroshi
H
Yoshikawa
Junichi
J
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
D013794:Thallium Radioisotopes; D000255:Adenosine Triphosphate