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Published on: April 13, 2015
Non-invasive assessment of coronary arterial tone using trans-thoracic Doppler echocardiography
Atsushi Takagi1, Yukio Tsurumi, Kotaro Arai
1Department of Cardiology, Tokyo Women's Medical University, Japan. mtakagi@hij.twmu.ac.jp
Insights
Transthoracic Doppler echocardiography (TTDE) effectively assesses coronary arterial tone. Measuring coronary flow velocity (CFV) and CFV reserve (CFVR) changes after nitroglycerin (NTG) administration provides a reliable method for evaluating arterial tone.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Vascular Physiology
Background:
- Coronary flow velocity (CFV) is inversely proportional to luminal size.
- Elevated arterial tone can manifest as increased epicardial artery flow velocity.
- Transthoracic Doppler echocardiography (TTDE) is explored for assessing coronary arterial tone.
Purpose of the Study:
- To evaluate the utility of TTDE in assessing coronary arterial tone.
- To determine if TTDE can measure changes in coronary blood flow in response to vasodilators.
Main Methods:
- 32 patients underwent TTDE and coronary angiography.
- Quantitative coronary angiography measured left anterior descending artery (LAD) luminal diameter (LD) before and after nitroglycerin (NTG).
- TTDE measured LAD CFV and CFV reserve (CFVR), assessing changes post-NTG (CFV(NTG/Pre), CFVR(NTG/Pre)).
Main Results:
- NTG administration increased LAD LD (p<0.001).
- Simultaneously, LAD CFV decreased (p<0.03) and CFVR increased (p<0.001) post-NTG.
- Significant correlations were found between changes in CFV/CFVR and changes in LD post-NTG (R2=0.532 and R2=0.715, respectively).
Conclusions:
- TTDE is a valuable tool for assessing coronary arterial tone.
- Measuring the response of CFV and CFVR to NTG administration via TTDE reliably indicates coronary arterial tone.
Background:
As coronary flow velocity (CFV) is inversely related to the luminal size that exists for the myocardial bed, the elevated arterial tone can be assessed as the higher flow velocity in the epicardial artery. We examined the usefulness of transthoracic Doppler echocardiography (TTDE) for the assessment of coronary arterial tone.
Methods And Results:
A total of 32 patients underwent TTDE and angiography. The luminal diameter (LD) in the left anterior descending artery (LAD) was measured by using quantitative coronary angiography before and after nitroglycerin (NTG) administration. The ratio of post NTG LD to the control (LD(NTG/Pre)) was assessed as a standard parameter of coronary arterial tone. We also measured CFV and CFV reserve (CFVR) at the LAD by TTDE. We evaluated the change of CFV (CFV(NTG/Pre)) and CFVR (CFVR(NTG/Pre)) following NTG administration. The LD increased from 1.98+/-0.46 to 2.51+/-0.34 mm (p<0.001), while the CFV decreased from 23.9+/-10.0 to 16.3+/-5.6 cm/s (p<0.03), and the CFVR increased from 2.39+/-0.65 to 3.56+/-1.12 (p<0.001). There were significant correlations between CFV(NTG/Pre) and LD(NTG/Pre) (p<0.0001, R2 = 0.532), and between the CFVR(NTG/Pre) and LD(NTG/Pre) (p<0.0001, R2 = 0.715).
Conclusion:
TTDE can assess the coronary arterial tone by measuring the responses of CFV and CFVR to NTG administration.
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