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Preprocedural transthoracic Doppler echocardiography to identify stenosis associated with increased coronary flow

Masao Yamaguchi1, Masahiro Hoshino1, Tomoyo Sugiyama1

  • 1Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura City, Ibaraki, 300-0028, Japan.

Scientific Reports
|February 1, 2022
PubMed

Insights

Preprocedural transthoracic Doppler echocardiography (TDE) can predict increased coronary flow after percutaneous coronary intervention (PCI). Hyperemic LAD diastolic peak velocity (hDPV) measured by TDE helps identify lesions that benefit from PCI.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Interventional Cardiology

Background:

  • Percutaneous coronary intervention (PCI) benefits are linked to functional stenosis severity, often assessed by fractional flow reserve (FFR).
  • Predicting which coronary lesions will significantly improve flow post-PCI remains a clinical challenge.

Purpose of the Study:

  • To evaluate the predictive capability of preprocedural transthoracic Doppler echocardiography (TDE) for enhanced coronary blood flow after PCI.
  • To identify determinants of significant coronary flow increase following PCI.

Main Methods:

  • Analysis of 50 left anterior descending arteries (LAD) using TDE.
  • Hyperemic LAD diastolic peak velocity (hDPV) as a surrogate for coronary flow.
  • Calculation of % hDPV-increase to quantify flow changes post-PCI.

Main Results:

  • FFR improved post-PCI in all cases.
  • Mean hDPV increased significantly (53.0 to 76.0 mm/s, P < 0.01), with a median % hDPV-increase of 45%.
  • Pre-PCI FFR and hDPV were independent predictors of significant coronary flow increase.

Conclusions:

  • Preprocedural TDE-derived hDPV improves the identification of coronary lesions that benefit from PCI-induced revascularization.
  • TDE offers a valuable, non-invasive method to assess functional coronary flow reserve.

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