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Coronary flow velocity reserve measurement in three major coronary arteries using transthoracic Doppler
Eriko Murata1, Takeshi Hozumi, Yoshiki Matsumura
1Department of Internal Medicine and Cardiology, Osaka City University Medical School, Osaka, Japan.
Insights
Transthoracic Doppler echocardiography (TTDE) can noninvasively measure coronary flow velocity reserve (CFVR) to detect myocardial ischemia. This method shows high accuracy in identifying ischemic territories, aiding clinical diagnosis.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Noninvasive Assessment
Background:
- Coronary flow velocity reserve (CFVR) measured by transthoracic Doppler echocardiography (TTDE) is a potential noninvasive method for assessing coronary artery stenosis and myocardial ischemia.
- Clinical utility of TTDE for CFVR assessment in major coronary arteries requires further evaluation.
Purpose of the Study:
- To evaluate the diagnostic value of TTDE-derived CFVR in three major coronary arteries for detecting myocardial ischemia in a clinical setting.
- To compare the accuracy of CFVR measurements against a reference standard for myocardial ischemia detection.
Main Methods:
- Eighty-nine consecutive patients with chest pain underwent CFVR measurement using TTDE in three major coronary arteries.
- Myocardial ischemia was defined as CFVR < 2.0 in at least one vessel.
- Accuracy was determined by comparison with exercise thallium-201 (Tl-201) single photon emission computed tomography (SPECT).
Main Results:
- CFVR was successfully measured in 98% of patients (87/89).
- The sensitivity and specificity of CFVR < 2.0 for detecting myocardial ischemia were 86% and 89%, respectively.
- Agreement with Tl-201 SPECT varied by territory: 95% for LAD, 81% for PDA, and 73% for LCx.
Conclusions:
- Noninvasive CFVR measurement by TTDE is a valuable tool for detecting myocardial ischemia.
- TTDE-derived CFVR can effectively identify specific ischemic territories within the coronary arteries.
- This method offers a promising approach for clinical assessment of myocardial ischemia.
Background:
Measurement of the coronary flow velocity reserve (CFVR) by transthoracic Doppler echocardiography (TTDE) has been reported to be useful for the noninvasive assessment of significant coronary artery stenosis or myocardial ischemia. The purpose of this study was to evaluate the value of this method in three major coronary arteries for detecting myocardial ischemia in the clinical setting.
Methods:
We studied 89 consecutive patients who were referred to our outpatient clinic because of chest pain. We measured CFVR using TTDE in three major coronary arteries. We defined CFVR<2.0 in at least one vessel as being positive for myocardial ischemia. The accuracy of CFVR measurements for detecting myocardial ischemia was determined in comparison with exercise thallium-201 (Tl-201) single photon emission computed tomography (SPECT) as a reference standard.
Results:
CFVR in at least one vessel was successfully measured in 87 of 89 patients (98%). The sensitivity and specificity of CFVR<2.0 in at least one coronary vessel, in any of the coronary territories, was 86% and 89%, respectively. In terms of assessing myocardial ischemia in each coronary artery territory, the agreement between CFVR<2.0 and Tl-201 SPECT for the left anterior descending coronary artery, the posterior descending coronary artery, and the left circumflex coronary artery territories was 95%, 81%, and 73%, respectively.
Conclusion:
Noninvasive CFVR measurement by TTDE may be useful for detecting myocardial ischemia, as well as for identifying ischemic territories in the clinical setting.
