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Updated: Feb 19, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Successful percutaneous coronary intervention significantly improves coronary sinus blood flow as assessed by
Radmila Lyubarova1, William E Boden2, Steven A Fein3
1Division of Cardiology, Albany Medical College, 47 New Scotland Avenue, MC44, Albany, NY, 12208, USA. LyubarR@mail.amc.edu.
Insights
Transthoracic echocardiography (TTE) can effectively measure coronary sinus blood flow (CSBF) changes after successful percutaneous coronary intervention (PCI). This noninvasive method shows significant CSBF increase post-PCI, indicating improved coronary blood flow.
Area of Science:
- Cardiology
- Medical Imaging
- Vascular Physiology
Background:
- Coronary sinus blood flow (CSBF) assessed by transthoracic echocardiography (TTE) reflects total coronary arterial blood flow.
- Successful angioplasty is anticipated to enhance coronary arterial blood flow.
- Systematic evaluation of CSBF changes post-percutaneous coronary intervention (PCI) using TTE is lacking.
Purpose of the Study:
- To evaluate changes in coronary sinus blood flow (CSBF) following successful percutaneous coronary intervention (PCI) using transthoracic echocardiography (TTE).
- To determine if TTE can document improved coronary arterial blood flow after angioplasty.
Main Methods:
- A cohort of 31 patients with suspected coronary artery disease underwent TTE for CSBF measurement before and after cardiac catheterization with or without PCI.
- CSBF was calculated using TTE with two-dimensional and Doppler imaging.
- Repeated measures analysis of variance was used to assess CSBF changes.
Main Results:
- Technically adequate CSBF measurements were obtained in 77% of patients.
- Patients undergoing successful PCI showed a significant increase in CSBF (p < 0.01).
- Patients without PCI exhibited no significant change in CSBF (p = 0.36).
Conclusions:
- Transthoracic echocardiography is a viable method for documenting CSBF changes after angioplasty.
- Further research is warranted to explore the clinical utility of TTE for assessing CSBF post-PCI.
Background:
Transthoracic echocardiography (TTE) has been used to assess coronary sinus blood flow (CSBF), which reflects total coronary arterial blood flow. Successful angioplasty is expected to improve coronary arterial blood flow. Changes in CSBF after percutaneous coronary intervention (PCI), as assessed by TTE, have not been systematically evaluated.
Hypothesis:
TTE can be utilized to reflect increased CSBF after a successful, clinically indicated PCI.
Methods:
The study cohort included 31 patients (18 females, 62 ± 11 years old) referred for diagnostic cardiac catheterization for suspected coronary artery disease and possible PCI, when clinically indicated. All performed PCIs were successful, with good angiographic outcome. CSBF per cardiac cycle (mL/beat) was measured using transthoracic two-dimensional and Doppler flow imaging as the product of coronary sinus (CS) area and CS flow time-velocity integral. CSBF per minute (mL/min) was calculated as the product of heart rate and CSBF per cardiac cycle. In each patient, CSBF was assessed prospectively, before and after cardiac catheterization with and without clinically indicated PCI. Within- and between-group differences in CSBF before and after PCI were assessed using repeated measures analysis of variance.
Results:
Technically adequate CSBF measurements were obtained in 24 patients (77%). In patients who did not undergo PCI, there was no significant change in CSBF (278.1 ± 344.1 versus 342.7 ± 248.5, p = 0.36). By contrast, among patients who underwent PCI, CSBF increased significantly (254.3 ± 194.7 versus 618.3 ± 358.5 mL/min, p < 0.01, p-interaction = 0.03). Other hemodynamic and echocardiographic parameters did not change significantly before and after cardiac catheterization in either treatment group.
Conclusions:
Transthoracic echocardiographic assessment can be employed to document CSBF changes after angioplasty. Future studies are needed to explore the clinical utility of this noninvasive metric.
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