[High frequency transthoracic echocardiography in diagnosis of chronic occlusions of major coronary arteries].
Comparative analysis of possibilities of transthoracic echocardiography (TTE) and coronary angiography in diagnosis of chronic occlusions of anterior descending (ADA), circumflex (CA), and right coronary (RA) arteries was carried out in 100 patients (90 men, 10 women, mean age 51 +/- 11 years). With the help of TTE we analyzed direction, structural and temporal parameters of coronary blood flow in zones of potential epicardial and intramyocardial collateral filling: for ADA - in distal segment (dADA) and septal branches (SBADA), for CA - in obtuse marginal branches (OMB), for RCA - in posterior interventricular artery (PIA) and septal branches (SBRCA). We found that TTE was a sensitive and highly specific method of diagnosis of ADA and RCA occlusions, but did not allow to diagnose adequately occlusions of CA. We proved that main criterion of ADA occlusion was registration of retrograde or retroanterograde collateral blood flow in dADA or SBADA. Sensitivity of detection of inverted blood flow in dADA without consideration of direction of blood flow in SBADA in diagnosis of ADA occlusions was 77%, with consideration of SBRCA - 85%, specificity - 97%. Detection of retrograde or retroanterograde blood flow in SBADA was indicative of proximal level of artery lesion with sensitivity 100% and specificity 75%. Detection of retrograde or collateral flow in PIA or SBRCA was found to be main criterion of RCA occlusion. Sensitivity of detection of inverted blood flow in PIA without taking into account direction of blood flow in SBRCA in diagnosis of RCA occlusions was 77%, with consideration of SBRCA - 88%, specificity - 98%. The study of lat flow in SBRCA did not allow to determine accurately the level of artery lesion.
Boshchenko
A A
AA
Vrublevskiĭ
A V
AV
Karpov
R S
RS
D001783:Blood Flow Velocity; D002908:Chronic Disease; D003326:Coronary Circulation / Q000502:physiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003937:Diagnosis, Differential; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index