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Transthoracic Coronary Flow Data at Rest Predict High-Risk Stress Tests.
Angela Zagatina1, Nadezhda Zhuravskaya1, Yuliya Vareldzhyan1
11 Medika Cardiocenter, Saint Petersburg, Russian Federation.
Acta Radiologica (Stockholm, Sweden : 1987)
|September 30, 2017
Summary
Elevated coronary flow velocity at rest may indicate significant coronary artery narrowing. This study found a correlation between high resting velocities and abnormal heart wall motion during exercise echocardiography, suggesting a potential non-invasive diagnostic marker.
Area of Science:
- Cardiovascular Medicine
- Diagnostic Imaging
- Hemodynamics
Background:
- Recent studies suggest local flow acceleration can diagnose coronary artery narrowing without stress testing.
- Assessing coronary artery flow velocity at rest may offer a non-invasive diagnostic approach.
- Transthoracic Doppler echocardiography is a key tool in evaluating blood flow dynamics.
Purpose of the Study:
- To determine the frequency of positive exercise echocardiography tests in patients with elevated resting coronary flow velocities (≥ 0.70 m/s).
- To investigate the correlation between resting coronary flow velocities and exercise-induced cardiac abnormalities.
- To explore the potential of resting flow velocity as a predictor of significant coronary artery disease.
Main Methods:
- 150 patients undergoing exercise echocardiography were assessed using transthoracic Doppler echocardiography.
- Maximal diastolic coronary flow velocity was measured at rest in the left main/proximal left anterior/proximal left circumflex arteries (LM/pLAD/pLCx).
- Correlations were analyzed between peak velocities, ejection fraction, and indices of wall motion abnormalities (IWMA) during exercise. 62 angiograms were used for comparison.
Main Results:
- 16% of patients exhibited resting velocities > 0.70 m/s in the LM/pLAD/pLCx.
- Significant correlations were found between maximal LM/pLAD velocity and reduced ejection fraction (r ≈ -0.39, P < 0.0001) and increased IWMA (r ≈ 0.44, P < 0.0001) during exercise.
- Patients with elevated resting velocities showed severe ischemia on stress echocardiography, with an average IWMA of 2.3.
Conclusions:
- A significant correlation exists between elevated maximal coronary flow velocity at rest and the severity of exercise-induced wall motion abnormalities.
- Resting coronary flow velocity measurements may serve as a valuable, non-invasive indicator of significant coronary artery disease.
- This finding supports the potential of local flow acceleration as a diagnostic tool, reducing the need for stress testing in some cases.
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