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Assessment of Coronary Flow Velocity Reserve by Noninvasive Transthoracic Doppler Echocardiography in Patients with Angiographically Normal Coronary Arteries

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2005年第5期25卷 590-593,614页

作者：杨娅 Thomas BARTEL 李治安 raimund erbel Anzhen Hospital The Capital University of Medical Sciences Beijing 100029 China Department of Cardiology University Essen Essen 45122 Germany

Summary： The measurement of coronary flow velocity reserve （CFVR） by transthoracic Doppler echocardiography （TTDE） with invasive intracoronary Doppler flow wire technique （ICD） was validated and the pathological factors which influence CFVR in patients with angiographically normal coronary arteries were analyzed. CFVR was determined successfully in left anterior descending artery （LAD） in 37 of 40 patients with angiographically normal coronary arteries （men 22, women 15, age 20-75 years, mean age 54±12 years）. Coronary flow velocity was measured in the distal LAD by TTDE with contrast enhancement at baseline and during intravenous adenosine infusion of 110 μg/ kg per min within 48 h after ICD technique. Average peak velocity at baseline （APVb）, average peak velocity during hyperemia （APVh） and CFVR determined from TTDE were correlated closely with those from ICD measurements （APVb： y= 0. 64x＋ 5. 04, r=0. 86, P〈0. 001; APVh： y=0. 63x＋14. 36, r=0.82, P〈0.001; CFVR： y=0.65xq-0.92, r=0.88, P〈0.001）. For CFVR measurements, the mean differences between TTDE and ICD methods were 0. 12±0.39. CFVR in patients with history of hypertension was significantly lower than that in patients without history of hypertension （P〈0.05）. Intravascular ultrasound （IVUS） was performed in 34 patients. Plaque formation was found in LAD by IVUS in 17 （50%） patients. No significant difference in CFVR was found between the patients without plaque formation （3. 11±0. 49） and those with plaque formation （2. 76±0.53, P=0. 056）. It is suggested that TTDE with contrast enhancement provides reliable measurement of APV and CFVR in the distal ***. The early stage of atherosclerosis could be detected by IVUS, which may be normal in angiography. CFVR is impaired in patients with history of hypertension compared with that in patients without history of hypertension.

关键词： coronary flow velocity reserve angiographically normal coronary arteries thansthoracic Doppler echocardiography intracoronary Doppler

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Identification of syndrome X using intravascular ultrasound imaging and Doppler flow mapping

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Chinese Medical Journal 2004年第4期117卷 521-527页

作者：钱菊英葛均波樊冰王齐兵陈灏珠 Dietrich Baumgart Michael Haude raimund erbel Department of Cardiology Zhongshan Hospital Department of Cardiology

Background The purpose of this study was to assess the morphological changes and physiological function of coronary arteries in patients presenting with chest pain but having normal coronary angiograms, using intravascular ultrasound imaging (IVUS) and intracoronary Doppler (ICD) flow measurements, in order to elucidate the mechanism of syndrome X. Methods A total of 126 patients [67 males, 59 females, mean age (53.1±13.0) years] who experienced chest pain but had normal coronary angiograms were included in this study. ICD flow measurements of the left anterior descending coronary artery (LAD) were performed using a Cardiometrics FloMap Ⅱ system. Coronary flow velocity reserve (CFVR) was defined as the ratio of the average peak velocity during hyperemia to that at baseline, induced by an intracoronary bolus injection of 18 μg adenosine. A 3.2F or 2.9F 30 MHz mechanical rotating ultrasound catheter (CVIS, Boston Scientific) or a 3.0F 20MHz electronic ultrasound catheter (Endosonics) was used for IVUS. Results The mean CFVR value of the LAD was 2.71±0.74. Reduction of CFVR (<3.0) was found in 82 of 126 (65.1%) patients. IVUS images of the LAD were available for 109 patients. Plaque formation was detected in 76/109 (69.7%) patients. Based on the presence or absence of plaque formation as well as the reduction or non-reduction of CFVR, patients were divided into four groups: Group Ⅰ (n=10), normal IVUS findings and normal CFVR; Group Ⅱ (n=23), normal IVUS findings with reduction in CFVR; Group Ⅲ (n=29), IVUS evidence of plaque formation but normal CFVR; and Group Ⅳ (n=47), IVUS evidence of plaque formation with reduction in CFVR. Conclusion This study shows the important clinical value of a combination of IVUS and ICD in diagnosing patients with angiographically normal coronary arteries. Only 10% of patients studied (Group Ⅰ) were found to be truly free of coronary disease, while 20% of patients (Group Ⅱ) would be diagnosed as suffering from syndrome X.

关键词： coronary angiography Doppler ultrasound syndrome X

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SHORT-TERM REPRODUCIBILITY OF INTRAVASCULAR ULTRASOUND IN VIVO

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Chinese Medical Journal 1995年第3期 77-78页

作者： Gunter Gorge Michael Haude Mahmoud Ashry raimund erbel Dept of Cardiology University Essen. GermanyDept of Cardiology University Essen. GermanyDept of Cardiology University Essen. GermanyDept of Cardiology University Essen. Germany

We studied 24 patients (18 males, 56.1 ± 6.2 years) who underwent coronary artery angioplasty for stenosis in the left anterior descending coronary artery (LAD), using a 3.5F or 4.8F intravascular ultrasound (IVUS) c... 详细信息

关键词： IVUS LAD SHORT-TERM REPRODUCIBILITY OF INTRAVASCULAR ULTRASOUND IN VIVO

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Non-invasive Assessment of Coronary Flow Velocity Reserve: A New Method Using Transthoracic Doppler Echocardiography

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2002年第2期22卷 158-163页

作者：杨娅王新房 Thomas Bartel Holger Eggebrecht Loredana Latina Clemems von Birgelen Guido Caspari raimund erbel Institute of Cardiovascular Disease Xiehe Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Department of Cardiology University Essen Germany

Summary: Transthoracic Doppler echocardiography (TTDE) allows noninvasive flow measurement in the distal left anterior descending artery (LAD). The feasibility of detecting coronary flow by contrast-enhanced TTDE with second harmonic technique was assessed, the coronary flow velocity reserve (CFVR) was evaluated in comparison to intracoronary Doppler flow (ICD) analysis and the CFVR after PTCA in LAD was investigated. In 77 (96 %) of 80 patients, CFVR was successfully determined with intravenous adenosine infusion. Doppler signal quality was evaluated in the first 46 patients by use of intravenous Levovist infusion and second harmonic technique. The Doppler flow was not visible in 1 patient only. CFVR determined from TTDE (2.77±0.65) was correlated closely with those from ICD (2.88±0.78) measurements (y=0.73x+0.67, r=0.87, P<0.001). In conclusion, TTDE is a feasible method and provides reliable data on CFVR which can be used for follow-up after PTCA.

关键词： coronary flow velocity reserve Doppler echocardiography intracoronary Doppler

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A new method for internal cardioversion in patients with persistent atrial fibrillation

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Chinese Medical Journal 2002年第2期 139-141页

作者：周京敏 Stefan Sack Frank Heinzel Peter Hunold Nicklas Dagres raimund erbel 葛均波 Department of Cardiology Zhongshan Hospital Shanghai Institute of Cardiovascular Diseases Fudan University Department of Cardiology University Essen Hospital Essen 45122 Germany

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Accuracy of myocardial viability imaging by cardiac MRI and PET depending on left ventricular function

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World Journal of Cardiology 2018年第9期10卷 110-118页

作者： Peter Hunold Heinz Jakob raimund erbel Jorg Barkhausen Christina Heilmaier Clinic for Radiology and Nuclear Medicine University Hospital Schleswig-HolsteinCampus LübeckLübeck 23538Germany Department of Thoracic and Cardiovascular Surgery West German Heart CenterUniversity of Duisburg-EssenUniversity Hospital EssenEssen 45122Germany Department of Cardiology West German Heart CenterUniversity of Duisburg-EssenUniversity Hospital EssenEssen 45122Germany Department of Radiology and Nuclear Medicine Stadtspital TriemliZürich 8063Switzerland

AIM To compare myocardial viability assessment accuracy of cardiac magnetic resonance imaging(CMR)compared to[^(18)F]-fluorodeoxyglucose(FDG)-positron emission tomography(PET)depending on left ventricular(LV)*** One-hundred-five patients with known obstructive coronary artery disease(CAD)and anticipated coronary revascularization were included in the study and examined by CMR on a 1.5T *** CMR protocol consisted of cine-sequences for function analysis and late gadolinium enhancement(LGE)imaging for viability assessment in 8 mm long and contiguous short axis *** patients underwent PET using[^(18)F]-*** scars were rated in both CMR and PET on a segmental basis by a 4-point-scale:Score 1=no LGE,normal FDG-uptake;score 2=LGE enhancement50% :n=16).On a segmental basis,the accuracy of CMR in detecting myocardial scar was compared to PET in the total collective and in the three different patient *** CMR and PET data of all 105 patients were sufficient for evaluation and 5508 segments were compared in *** all patients,CMR detected significantly more scars(score 2-4)than PET:45% vs 40% of all segments(P50% (15% vs 23% ;P<0.0001).In terms of functional improvement estimation,i.e.,expected improvement after revascularization,CMR identified"viable"segments(score 1 and 2)in 72% of segments across all groups,PET in 80% (P<0.

关键词： Magnetic resonance imaging Positronemission tomography Myocardial infarction Coronary artery disease Myocardium Ventricular dysfunction

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冠脉造影正常伴心前区疼痛患者冠状动脉微血管功能的无创性超声多普勒评估

冠脉造影正常伴心前区疼痛患者冠状动脉微血管功能的无创性超声多...

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2003年全国医学影像技术学术会议

作者：杨娅李治安 Thomas Bartel raimund erbel 首都医科大学附属北京安贞医院超声影像科首都医科大学附属北京安贞医院超声影像科德国埃森大学医学院心内科德国埃森大学医学院心内科

目的①经胸多普勒超声心动图（TTDE）与冠脉内多普勒（ICD）相对照,分析TTDE探测冠脉造影正常者左前降支（LAD）远端血流的准确性;②分析冠脉造影正常者的冠脉微血管功能的变化。方法利用TTED探测35例冠脉造影正常者LAD远端的基础状态...

目的①经胸多普勒超声心动图（TTDE）与冠脉内多普勒（ICD）相对照,分析TTDE探测冠脉造影正常者左前降支（LAD）远端血流的准确性;②分析冠脉造影正常者的冠脉微血管功能的变化。方法利用TTED探测35例冠脉造影正常者LAD远端的基础状态及经静脉注入腺苷后的最大血流速度,计算冠状动脉血流速度储备（CFVR）、冠状动脉阻力（CVR）和最小冠状动脉阻力指数（CVRI）。并分析比较20例心前区疼痛患者（A组）和15例正常人（B组）上述冠脉血流参数测值。结果30例冠脉造影正常者TTDE所探测的基础状态血流速度（APVb）、最大充血反应状态血流速度（APVh）和CFVR与ICD的探测结果密切相关（r分别为0.79,0.83,0.85）。A组与B组APVb、APVh和CVR的差异均无显著性意义（P＞0.05）,A组CFVR低于B组,而CVRI高于B组,P值均＜0.05。结论TTDE是一项可行、可信的无创性探测CFVR的方法。冠脉造影正常伴心前区疼痛患者存在冠脉微循环功能障碍。

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冠脉造影正常者的冠脉血流储备分析:经胸多普勒冠脉血流显像与冠脉内超声和多普勒的对照分析

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中国医学影像技术 2004年第9期20卷 1355-1358页

作者：杨娅 Thomas Bartel 李治安 raimund erbel 首都医科大学附属北京安贞医院超声影像科北京100029 德国埃森大学医学院心内科德国45122

目的　经胸多普勒超声心动图与冠状动脉内超声 (IVUS)相结合 ,探讨冠脉造影正常者的冠状动脉形态及血流动力学变化。方法　探测 47例冠脉造影正常者前降支 (LAD)IVUS及血流速度并计算冠脉血流储备 (CFVR)。结果　 47例患者中 ,14例 (3 0... 详细信息

目的　经胸多普勒超声心动图与冠状动脉内超声 (IVUS)相结合 ,探讨冠脉造影正常者的冠状动脉形态及血流动力学变化。方法　探测 47例冠脉造影正常者前降支 (LAD)IVUS及血流速度并计算冠脉血流储备 (CFVR)。结果　 47例患者中 ,14例 (3 0 % )LAD内无斑块 ,CFVR正常 ;16例 (3 4% )无斑块 ,CFVR减低 ;9例 (19% )有斑块 ,CFVR正常 ;8例 (17% )有斑块 ,CFVR减低。结论　冠脉造影正常者中仅 3 0 %为真正的正常 ,其余患者冠脉内或有斑块形成和 /或CFVR受损。

关键词：超声心动描记术多普勒血流冠状动脉

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冠状动脉血流储备的经胸多普勒超声心动图与冠状动脉内多普勒血流测量的对照研究

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中华超声影像学杂志 2002年第6期11卷 325-328页

作者：杨娅 Thomas Bartel 王新房 raimund erbel 华中科技大学同济医学院附属协和医院心血管病研究所超声影像科武汉430022 Department of Cardiology University EssenGermany45122

目的　①探讨经胸声学造影二次谐波多普勒超声心动图 (TTDE)探测冠状动脉左前降支(LAD)远端血流的可行性 ;②与冠状动脉内多普勒 (ICD)相对照 ,分析研究LAD冠状动脉血流储备(CFR)。方法　利用TTDE连续检测 110例患者LAD血流。冠状动脉... 详细信息

目的　①探讨经胸声学造影二次谐波多普勒超声心动图 (TTDE)探测冠状动脉左前降支(LAD)远端血流的可行性 ;②与冠状动脉内多普勒 (ICD)相对照 ,分析研究LAD冠状动脉血流储备(CFR)。方法　利用TTDE连续检测 110例患者LAD血流。冠状动脉血流速度储备 (CFVR)为注射腺苷后的最大平均血流速度与静息状态平均血流速度的比值。结果　CFVR探测的成功率为 96%。TTDE所探测的CFVR(2 .83± 0 .68)与ICD所探测的结果 (2 .91± 0 .74)密切相关 (r =0 .83 ,Y =0 .76X + 0 .61,P <0 .0 0 1)。结论　TTDE结合声学造影及二次谐波技术是一项可行、可信的无创性探测CFVR的方法 ,可用于冠状动脉病变的探测及冠脉介入治疗的随访。

关键词：血流测量对照研究超声心动描记术多普勒造影剂冠状动脉血流储备

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冠状动脉造影正常伴心前区疼痛患者冠状动脉微血管功能的无创性超声多普勒评估

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中华超声影像学杂志 2004年第6期13卷 408-411页

作者：杨娅 Thomas Bartel 李治安 raimund erbel 首都医科大学附属北京安贞医院超声影像科北京100029 Abteilung fr Kardiologie Universittsklinikum Essen

目的　经胸多普勒超声心动图 (TTDE)与冠状动脉内多普勒 (ICD)相对照 ,分析TTDE探测冠状动脉造影正常者左前降支 (LAD)远端血流的准确性 ;分析冠状动脉造影正常者冠状动脉微血管功能的变化。方法　利用TTDE探测 3 5例冠状动脉造影正常者... 详细信息

目的　经胸多普勒超声心动图 (TTDE)与冠状动脉内多普勒 (ICD)相对照 ,分析TTDE探测冠状动脉造影正常者左前降支 (LAD)远端血流的准确性 ;分析冠状动脉造影正常者冠状动脉微血管功能的变化。方法　利用TTDE探测 3 5例冠状动脉造影正常者LAD远端的基础状态及经静脉注入腺苷后的最大血流速度 ,计算冠状动脉血流速度储备 (CFVR)、冠状动脉阻力 (CVR )和最小冠状动脉阻力指数 (CVRI)。分析比较 2 0例心前区疼痛患者 (A组 )和 15例正常人 (B组 )上述冠状动脉血流参数测值。结果　 3 5例冠状动脉造影正常者TTDE所探测的基础状态血流速度 (APVb)、最大充血反应状态血流速度 (APVh)和CFVR与ICD的探测结果密切相关 (r分别为 0 .79,0 .83 ,0 .85 )。A组与B组APVb、APVh和CVR的差异均无显著性意义 (P >0 .0 5 ) ,但A组CFVR低于B组 ,而CVRI高于B组 (均P <0 .0 5 )。结论　TTDE是一项可行、可信的无创性探测CFVR的方法。冠状动脉造影正常伴心前区疼痛患者存在冠状动脉微循环功能障碍。

关键词：冠状动脉造影正常心前区疼痛冠状动脉微血管功能无创性超声多普勒超声心动图

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