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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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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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