CLINICAL STUDIES
Noninvasive assessment of coronary flow velocity and coronary flow velocity reserve in the left anterior descending coronary artery by Doppler echocardiography
Comparison with invasive technique
Takeshi Hozumi, MDa,
Kiyoshi Yoshida, MD, FACCa,
Takashi Akasaka, MDa,
Yoshio Asami, MDa,
Yumiko Ogata, MDa,
Tsutomu Takagi, MDa,
Shuichiro Kaji, MDa,
Takahiro Kawamoto, MDa,
Yoshiaki Ueda, MDa and
Shigefumi Morioka, MDa
a Division of Cardiology, Kobe General Hospital, Kobe, Japan
Manuscript received March 27, 1998;
revised manuscript received June 25, 1998,
accepted July 15, 1998.
Address for correspondence: Dr. Takeshi Hozumi, Division of Cardiology, Kobe General Hospital, 4-6 Minatojima-nakamachi, Chuo-ku, Kobe 650, Japan
jse{at}warp.or.jp
Objectives. The purpose of this study was to evaluate whether transthoracic Doppler echocardiography (TTDE) can reliably measure coronary flow velocity (CFV) and coronary flow velocity reserve (CFVR) in the left anterior descending coronary artery (LAD) in the clinical setting.
Background. Coronary flow velocity measurement has provided useful clinical and physiologic information. Advancement in TTDE provides noninvasive measurement of CFV and CFVR in the distal LAD.
Methods. In 23 patients, CFV in the distal LAD was measured by TTDE (5 or 3.5 MHz) under the guidance of color Doppler flow mapping at the time of Doppler guide wire (DGW) examination. Coronary flow velocity in the distal LAD were measured at baseline and hyperemic conditions (intravenous administration of adenosine 0.14 mg/kg/min) by both TTDE and DGW techniques. Coronary flow velocity reserve was defined as the ratio of peak hyperemic to basal averaged peak velocity in the distal LAD.
Results. Clear envelopes of basal and hyperemic CFV in the distal LAD were obtained in 18 (78%) of 23 study patients by TTDE. There were excellent correlations between TTDE and DGW methods for the measurements of CFV (averaged peak velocity: r = 0.97, y = 0.94x + 0.40; averaged diastolic peak velocity: r = 0.97, y = 0.94x + 0.69; systolic peak velocities: r = 0.97, y = 0.91x + 0.87; diastolic peak velocity: r = 0.98, y = 0.95x + 1.10). Coronary flow velocity reserve from TTDE correlated highly with those from DGW examinations (r = 0.94, y = 0.95x + 0.21).
Conclusions. Noninvasive measurement of CFV and CFVR in the distal LAD using TTDE accurately reflects invasive measurement of CFV and CFVR by DGW method.
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Abbreviations and Acronyms
| | ADPV | = averaged diastolic peak velocity | | APV | = averaged peak velocity | | ASPV | = averaged systolic peak velocity | | CFV | = coronary flow velocity | | CFVR | = coronary flow velocity reserve | | DGW | = Doppler guide wire | | DPV | = diastolic peak velocity | | LAD | = left anterior descending coronary artery | | TTDE | = transthoracic Doppler echocardiography |
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