Using transthoracic Doppler echocardiography to diagnose reduced coronary flow velocity reserve in the posterior descending coronary artery in children with elevated right ventricular pressure.
BACKGROUND
Advances in transthoracic Doppler echocardiography enable noninvasive measurements of coronary flow velocity and coronary flow velocity reserve (CFVR) in the posterior descending coronary artery (PD).


RESULTS
To evaluate CFVR in the PD of children with elevated right ventricular (RV) pressure, 19 children with RV pressure overload and 13 age-matched controls with normal RV pressure were studied using transthoracic Doppler echocardiography. Average peak flow velocity (APV) was measured at rest and in hyperemic conditions (intravenous administration of adenosine of 0.16 mg.kg(-1).min(-1)). Compared with controls, the PD CFVR was significantly reduced in the patients with elevated RV pressure (1.87+/-0.42 vs 2.49+/-0.55, p<0.01) because their mean baseline APV was significantly greater (27+/-6 vs 19+/-4 cm/s, p<0.01), although hyperemic APV was not significantly different (49+/-10 vs 48+/-14 cm/s, p=NS).


CONCLUSIONS
PD CFVR is limited in patients with elevated RV pressure because of elevation of the baseline resting flow velocity.
Shimada
Shunsuke
S
Department of Pediatrics, Akita University School of Medicine, Japan. syunsuke@doc.med.akita-u.ac.jp
Harada
Kenji
K
Toyono
Manatomo
M
Tamura
Masamichi
M
Takada
Goro
G
D000241:Adenosine / Q000494:pharmacology; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015150:Echocardiography, Doppler / Q000379:methods; D006801:Humans; D007223:Infant; D014665:Vasodilator Agents / Q000494:pharmacology; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology
D014665:Vasodilator Agents; D000241:Adenosine