title: Role of transthoracic Doppler-determined coronary flow reserve in patients with chest pain.
abstract: BACKGROUND
  The assessment of patients with chest pain is an important step to make a diagnosis and clinical decision. Coronary flow reserve (CFR) can be used for the screening of significant coronary stenosis. However, the feasibility and limitation of CFR in those patients remains unknown.
  
  
  RESULTS
  A total of 100 patients with chest pain were examined. CFR was measured in all 3 major coronary arteries by using transthoracic Doppler echocardiography (TTDE). Coronary angiography was performed 1 to 3 days after TTDE. CFR in all 3 major coronary arteries could be measured in 83 (83%) of 100 patients. The echo-contrast agent was useful in 32 of 49 patients who had unclear color Doppler images. When CFR <2.0 was regarded as the cut-off point, the overall agreement rate between CFR and the results of coronary angiography was 83% (69 of the 83 patients). In addition, CFR could predict the presence of coronary artery disease satisfactorily (sensitivity 85%, specificity 81%, positive predictive value 89%, negative predictive value 93%).
  
  
  CONCLUSIONS
  TTDE seems to be a promising tool for screening patients with chest pain. Moreover, an echo-contrast agent seems to be an effective and supportive tool for patients who have poor visualization of coronary flow.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita 565-8565, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Kataoka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nakatani
authors.forename: Norio
authors.initials: N
authors.lastname: Tanaka
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kanzaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasuda
authors.forename: Isao
authors.initials: I
authors.lastname: Morii
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawamura
authors.forename: Shunichi
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kitakaze
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D002637:Chest Pain / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged