CLINICAL STUDY
Noninvasive assessment of microvascular function in arterial hypertension by transthoracic doppler harmonic echocardiography
Thomas Bartel, MD*,*,
Y. a Yang, MD*,
Silvana Müller, MD ,
René R. Wenzel, MD ,
Dietrich Baumgart, MD*,
Thomas Philipp, MD and
Raimund Erbel, MD, FACC*
* Cardiology Division, Department of Internal Medicine, University of EssenEssen, Germany
Cardiology Division, Department of Internal Medicine, University of Innsbruck, Innsbruck, Austria
Division of Nephrology and Hypertension, Department of Internal Medicine, University of Essen, Essen, Germany
Manuscript received November 29, 2001;
revised manuscript received March 19, 2002,
accepted April 3, 2002.
* Reprint requests and correspondence: Dr. Thomas Bartel, Division of Cardiology, Department of Internal Medicine, University of Essen, Hufelandstr. 55, 45122 Essen, Germany.
thomas.bartel{at}uni-essen.de
OBJECTIVES: The present study sought to investigate the use of transthoracic Doppler harmonic echocardiography (TTDHE) to evaluate changes in coronary flow dynamics due to microvascular dysfunction.
BACKGROUND: Coronary flow velocity reserve (CFVR) measurements by TTDHE are useful for assessing epicardial coronary artery stenoses. It remains unclear, however, if microvascular disease can be detected.
METHODS: In 54 patients with chest pain, intracoronary Doppler (ICD) and TTDHE were used to measure average peak velocity at baseline and hyperemia. Significant coronary lesions had been ruled out by both angiography and intravascular ultrasound. Comparative measurements were performed in the distal left anterior descending coronary artery after intracoronary and intravenous administration of adenosine, and CFVR was calculated. Hypertensive patients (n = 25) were studied and compared to a control group (26 normotensive individuals).
RESULTS: Three patients (5%) had to be excluded because of insufficient image quality or side effects. In both groups, TTDHE-derived CFVR data correlated closely with ICD measurements (group 1: y = 0.67x + 0.076, standard error of estimate [SEE] = 0.25, r = 0.87, p < 0.001; group 2: y = 0.64x + 1.11, SEE = 0.26, r = 0.87, p < 0.001). CFVR was lower in hypertensives than in normotensive controls (2.44 ± 0.49 vs. 3.33 ± 0.40, p < 0.001, cut point = 2.84).
CONCLUSIONS: The newly described echocardiographic method is suitable for assessing microvascular dysfunction noninvasively and corresponds well to invasive measurements.
|
Abbreviations and Acronyms
| | APV | | average peak velocity | | bAPV | | baseline average peak velocity | | bMDV | | baseline mean diastolic velocity | | bMSV | | baseline mean systolic velocity | | bPSV | | baseline peak systolic velocity | | CFVR | | coronary flow velocity reserve | | hAPV | | hyperemic average peak velocity | | ICD | | intracoronary Doppler | | MDV | | mean diastolic velocity | | MSV | | mean systolic velocity | | PDV | | peak diastolic velocity | | PSV | | peak systolic velocity | | TTDHE | | transthoracic Doppler harmonic echocardiography |
|
This article has been cited by other articles:
|
|
|
|
 
B. Biondi, M. Galderisi, L. Pagano, M. Sidiropulos, M. Pulcrano, A. D' Errico, S. Ippolito, A. Rossi, O. de Divitiis, and G. Lombardi
Endothelial-mediated coronary flow reserve in patients with mild thyroid hormone deficiency
Eur. J. Endocrinol.,
August 1, 2009;
161(2):
323 - 329.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. R. Pries, H. Habazettl, G. Ambrosio, P. R. Hansen, J. C. Kaski, V. Schachinger, H. Tillmanns, G. Vassalli, I. Tritto, M. Weis, et al.
A review of methods for assessment of coronary microvascular disease in both clinical and experimental settings
Cardiovasc Res,
November 1, 2008;
80(2):
165 - 174.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M Saito, H Okayama, K Nishimura, A Ogimoto, T Ohtsuka, K Inoue, G Hiasa, T Sumimoto, and J Higaki
Possible link between large artery stiffness and coronary flow velocity reserve
Heart,
June 1, 2008;
94(6):
e20 - e20.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Valzania, F. Gadler, R. Winter, F. Braunschweig, L.-A. Brodin, P. Gudmundsson, G. Boriani, and M. J. Eriksson
Effects of cardiac resynchronization therapy on coronary blood flow: Evaluation by transthoracic Doppler echocardiography
Eur J Heart Fail,
May 1, 2008;
10(5):
514 - 520.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. Ikonomidis, J. T. Parissis, I. Paraskevaidis, K. Kourea, V. Bistola, J. Lekakis, G. Filippatos, and D. Th. Kremastinos
Effects of levosimendan on coronary artery flow and cardiac performance in patients with advanced heart failure
Eur J Heart Fail,
December 1, 2007;
9(12):
1172 - 1177.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Wieneke, K. Sattler, C. von Birgelen, D. Bose, M. Haude, W. Rechenberg, S. Sack, N. Dagres, and R. Erbel
Impact of intraventricular conduction delay on coronary haemodynamics: a study with intracoronary Doppler in patients with bundle branch blocks and normal coronary arteries.
Europace,
March 1, 2006;
8(3):
151 - 156.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Voci, F. Pizzuto, and F. Romeo
Coronary flow: a new asset for the echo lab?
Eur. Heart J.,
November 1, 2004;
25(21):
1867 - 1879.
[Full Text]
[PDF]
|
|
|
|
