Related Experiment Videos
Assessment of coronary flow reserve with transthoracic Doppler echocardiography: comparison with intracoronary
1Department of Internal Medicine, Korea University College of Medicine, Seoul.
Insights
Transthoracic Doppler echocardiography (TTDE) shows promise for non-invasively measuring coronary flow velocity and evaluating coronary flow reserve (CFR). This method offers a feasible alternative to intracoronary Doppler wire for assessing coronary artery function.
Area of Science:
- Cardiology
- Medical Imaging
- Physiology
Background:
- Assessing coronary flow reserve (CFR) is crucial for diagnosing coronary artery disease.
- Intracoronary Doppler wire (ICDW) is an invasive gold standard for CFR measurement.
- Non-invasive methods are sought to improve patient safety and accessibility.
Purpose of the Study:
- To evaluate the feasibility and usefulness of transthoracic Doppler echocardiography (TTDE) for measuring distal left anterior descending (LAD) coronary flow velocity.
- To compare CFR measurements obtained by TTDE with those from ICDW.
- To determine the correlation between TTDE and ICDW in assessing coronary hemodynamics.
Main Methods:
- Twenty-one patients without LAD stenosis were studied.
- Coronary flow reserve was measured using both TTDE and ICDW after adenosine administration.
- Doppler recordings of coronary flow velocities were analyzed at baseline and during hyperemia.
Main Results:
- Adequate Doppler recordings were obtained in 67% (systole) and 81% (diastole) of patients via TTDE.
- Baseline and hyperemic peak diastolic flow velocities by TTDE were lower than ICDW (p<0.05).
- Similar trends in diastolic/systolic velocity ratios were observed with both methods, with significant correlation (r=0.72, p<0.01).
Conclusions:
- TTDE is a feasible method for measuring coronary flow velocity.
- TTDE shows promise as a non-invasive tool for evaluating coronary flow reserve.
- This technique may offer a valuable alternative to invasive methods for coronary artery assessment.
Abstract:
To evaluate the feasibility and usefulness of transthoracic Doppler echocardiography (TTDE) as a non-invasive method in recording distal anterior descending (LAD) coronary flow velocity, we compared coronary flow reserve (CFR) measured by TTDE with measurements by intracoronary Doppler wire (ICDW). Twenty-one patients without LAD stenosis were studied. ICDW performed at baseline and after intracoronary injection of 18 microg adenosine. TTDE was performed at baseline and after intravenous adenosine (140 microg/kgmin for 2 min). Adequate Doppler recordings of coronary flow velocities during systole were obtained in 14 of 21 study patients (67%) and during diastole in 17 (81%) patients. Baseline and hyperemic peak diastolic flow velocities measured by TTDE were significantly smaller than those obtained by ICDW (p<0.05). However, diminishing trends of diastolic and systolic velocity ratio after hyperemia were similarly observed in both methods. CFR obtained by TTDE (3.0+/-0.5), was higher than the value calculated by ICDW (2.5+/-0.4). There were significant correlations between the values obtained by the two methods (r=0.72, p<0.01). It is concluded that TTDE is a feasible method in measuring coronary flow velocity and appears to be a promising non-invasive method in evaluating CFR.