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Published on: April 13, 2015
Clinical application of transthoracic Doppler echocardiography to assess coronary flow reserve
12nd Department of Cardiology CMUJ, ul. Kopernika 1731-501 Kraków. dimitrow@mp.pl
Insights
This review explains how to measure coronary circulation using Doppler echocardiography. Coronary flow reserve assessment is key for diagnosing coronary artery stenosis and microvascular dysfunction.
Area of Science:
- Cardiology
- Physiology
Background:
- Coronary circulation assessment is vital for understanding heart conditions.
- Coronary flow reserve (CFR) is a key functional parameter in coronary pathophysiology.
Purpose of the Study:
- To review methods for measuring coronary endothelium-independent and endothelium-dependent vasodilation.
- To highlight the significance of CFR in assessing coronary artery stenosis and microvascular integrity.
Main Methods:
- Focus on noninvasive transthoracic Doppler echocardiography.
- Measurement of coronary endothelium-independent and endothelium-dependent vasodilation.
Main Results:
- CFR assessment aids in evaluating epicardial coronary stenoses.
- CFR is crucial for diagnosing microvascular circulation impairments.
Conclusions:
- CFR is an important hemodynamic parameter for clinical decisions regarding intermediate coronary stenosis.
- Reduced CFR indicates impaired microvascular function in conditions like hypertension, diabetes, and hypercholesterolemia.
Abstract:
This review discusses methods (focusing on noninvasive transthoracic Doppler echocardiography) to measure coronary endothelium-independent and endothelium-dependent vasodilatation. Coronary flow reserve is an important functional parameter to understand the pathophysiology of coronary circulation. Coronary flow reserve measurement is used to assess epicardial coronary stenoses or to examine the integrity of microvascular circulation. In the presence of coronary artery stenosis, coronary flow reserve is an important hemodynamic parameter for clinical decision making (for example to refer or defer patients with intermediate stenosis [40-70%] to PTCA). In the absence of stenosis in the epicardial coronary artery, the coronary flow reserve may be decreased when coronary microvascular circulation is impaired by arterial hypertension with or without left ventricular hypertrophy, diabetes mellitus, hypercholesterolemia, hypertrophic cardiomyopathy, aortic stenosis or syndrome X.
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