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Identification of syndrome X using intravascular ultrasound imaging and Doppler flow mapping

Ju-Ying Qian1, Jun-Bo Ge, Bing Fan

  • 1Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China.

Chinese Medical Journal
|April 28, 2004
PubMed

Insights

Intravascular ultrasound imaging (IVUS) and intracoronary Doppler (ICD) reveal coronary artery disease in patients with chest pain and normal angiograms. Many patients diagnosed with syndrome X have underlying plaque or reduced coronary flow velocity reserve (CFVR).

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Vascular Biology

Background:

  • Chest pain with normal coronary angiograms suggests Syndrome X.
  • The underlying mechanisms of Syndrome X remain unclear.
  • Advanced imaging may reveal subtle coronary artery disease.

Purpose of the Study:

  • To assess morphological changes and physiological function of coronary arteries in patients with chest pain and normal angiograms.
  • To elucidate the mechanism of Syndrome X using intravascular ultrasound imaging (IVUS) and intracoronary Doppler (ICD).
  • To evaluate the diagnostic value of combining IVUS and ICD in this patient group.

Main Methods:

  • 126 patients with chest pain and normal coronary angiograms were included.
  • Intracoronary Doppler (ICD) measured coronary flow velocity reserve (CFVR) in the left anterior descending artery.
  • Intravascular ultrasound imaging (IVUS) assessed coronary plaque formation.

Main Results:

  • Reduced CFVR (<3.0) was observed in 65.1% of patients.
  • Plaque formation was detected by IVUS in 69.7% of patients.
  • Only 10% of patients had normal IVUS and normal CFVR; 20% met criteria for Syndrome X (normal IVUS, reduced CFVR).

Conclusions:

  • Combining IVUS and ICD is valuable for diagnosing patients with angiographically normal coronary arteries.
  • A significant proportion of patients with chest pain and normal angiograms have underlying coronary artery disease.
  • Intracoronary Doppler and IVUS can identify Syndrome X patients with normal coronary arteries but reduced flow or plaque.
Abstract

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