[Transthoracic Doppler echocardiographic detection of intramyocardial coronary artery flow in humans using high frequency transducer]
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Published on: April 13, 2015
Insights
Transthoracic Doppler echocardiography noninvasively detects intramyocardial coronary artery flow in humans. This method revealed significantly higher flow velocities in hypertrophic cardiomyopathy patients compared to healthy subjects.
Area of Science:
- Cardiovascular Imaging
- Echocardiography
- Hemodynamics
Background:
- Intramyocardial coronary artery flow is crucial for myocardial perfusion.
- Assessing this flow noninvasively can aid in diagnosing and managing cardiac conditions.
- Hypertrophic cardiomyopathy (HCM) is associated with altered myocardial structure and function.
Purpose of the Study:
- To evaluate the efficacy of transthoracic color and pulsed Doppler echocardiography in detecting intramyocardial coronary artery flow in humans.
- To compare intramyocardial flow velocities between healthy subjects and patients with HCM.
Main Methods:
- Utilized transthoracic color and pulsed Doppler echocardiography with 10-5 or 7-4 MHz transducers.
- Measured intramyocardial coronary artery flow velocity at the interventricular septum and apex.
- Included 18 healthy subjects and 16 patients with HCM.
Main Results:
- Color Doppler signals were detected in 83% of normal subjects and 94% of HCM patients at the septum.
- Pulsed Doppler identified systolic (S-wave) and diastolic (D-wave) flow velocities in 61% of normal subjects and 88% of HCM patients at the septum.
- Mean peak S- and D-wave velocities were significantly higher in HCM patients (27±9 and 86±23 cm/sec) than in normal subjects (18±4 and 54±11 cm/sec).
- At the apex, color Doppler signals were detected in 78% of normal subjects and 100% of HCM patients.
- Pulsed Doppler measured apical flow velocities in 56% of normal subjects and 94% of HCM patients.
- Mean peak apical flow velocities were significantly higher in HCM patients (74±27 cm/sec) than in normal subjects (33±13 cm/sec).
Conclusions:
- Transthoracic color and pulsed Doppler echocardiography can reliably detect intramyocardial coronary artery flow noninvasively.
- Significantly elevated intramyocardial flow velocities were observed in patients with HCM at both the septum and apex.
- This technique holds potential for evaluating myocardial perfusion abnormalities in conditions like HCM.
Abstract:
The use of transthoracic color and pulsed Doppler echocardiography to detect intramyocardial coronary artery flow in humans was evaluated in 18 normal healthy subjects (mean age 54 years) and in 16 patients with hypertrophic cardiomyopathy (HCM; mean age 59 years) to measure the intramyocardial coronary artery flow velocity at the ventricular septum and the apex using a 10-5 or 7-4 MHz transducer. Linear inflow color Doppler signals which passed the interventricular septum were demonstrated in 15 of 18 normal subjects (83%) and 15 of 16 patients with HCM (94%). The phasic flow velocities measured by pulsed Doppler echocardiography consisted of two forward flow signals in mid-systole (S-wave) and holodiastole (D-wave), and were obtained in 11 of 18 in normal subjects (61%) and 14 of 16 patients with HCM (88%). The mean peak velocities of the S- and D-waves in patients with HCM (mean [+/-SD] 27 +/- 9 and 86 +/- 23 cm/sec, respectively) were significantly (p < 0.05) higher than those in normal subjects (18 +/- 4 and 54 +/- 11 cm/sec, respectively). At the apex, linear inflow color Doppler signals which passed the myocardium perpendicularly during the whole diastole were demonstrated in 14 of 18 normal subjects (78%) and all 16 patients with HCM (100%). The phasic flow velocities were measured by pulsed Doppler echocardiography in 10 of 18 normal subjects (56%) and 15 of 16 patients with HCM (94%). The mean peak velocities in patients with HCM (74 +/- 27 cm/sec) were significantly (p < 0.05) higher than those in normal subjects (33 +/- 13 cm/sec). Transthoracic color and pulsed Doppler echocardiography can detect intramyocardial coronary artery flow in humans at the interventricular septum and the apex noninvasively.
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