Advertisement

Value of acceleration flow in the left anterior descending coronary artery for the detection of coronary artery stenosis by transthoracic coronary color doppler echocardiography

  • Chen Bin
  • Deng Youbin
  • Yang Haoyi
  • Ruan Yanfei
  • Chang Qing
  • Bi Xiaojun
  • Wang Hongying
Article

Summary

Whether the localized flow acceleration occurs in the resting stenotic left anterior descending coronary artery was explored and its value for detection of coronary stenosis estimated. Blood flow in the left anterior descending coronary arteries in 45 patients was detected by transthoracic color Doppler echocardiograph and multipoint pulse Doppler spectrums were recorded in the same segment. The ratio of the maximal peak diastolic velocity to the minimal peak diastolic velocity was calculated. The ratio ≥1.5 was the cutoff value for the presence of localized acceleration flow. There were 23 patients with localized acceleration flow examined by echocardiography. Twenty of them were found to have luminal diameter stenosis (60%–98%) in the left anterior descending coronary arteries by coronary angiography and 3 patients were normal. There were 22 patients without localized acceleration flow examined by echocardiography. Eighteen of them had no or <60% stenosis. Four patients had serious stenosis (≥95%) or occluded segments in the left anterior descending coronary arteries on coronary angiography. The ratio of the maximal peak diastolic velocity to the minimal peak diastolic velocity was significantly higher in patients with left anterior descending coronary artery stenosis than that in those without stenosis (1.9±0.3 (vs 1.3±0.2,P<0.01) and it correlated significantly with left anterior descending coronary artery stenosis (r=0.77,P<0.01). The specificity by using the ratio≥1.5 for stenosis detection was 85.7% (18/21), and the sensitivity was 83.3% (20/24). This study demonstrated that local blood flow velocity was increased in the resting stenotic left anterior descending coronary artery. Transthoracic color Doppler echocardiography is a reliable noninvasive method to detect localized acceleration flow in the left anterior descending coronary artery stenosis and it is useful in the noninvasive diagnosis of stenosis in the left anterior descending coronary artery.

Key words

echocardiography coronary artery stenosis color Doppler flow imaging 

References

  1. 1.
    Yang Y, Thomas B, Wang X Fet al. Comparative analysis on coronary flow velocity reserve in patients with angiographically normal coronary arteries by transthoracic Doppler echocardiography with intravascular ultrasound and intracoronary Dopper. Chin J Ultrasonogr (Chinese), 2002, 10: 325Google Scholar
  2. 2.
    Hozumi T, Yoshida K, Akasaka Tet al. Value of acceleration flow and the prestenotic to stenotic coronary flow velocity ratio by transthoracic color Doppler echocardiography in noninvasive diagnosis of restenosis after percutaneous transluminal coronary angioplasty. J Am Coll Cardiol, 2003, 35: 164CrossRefGoogle Scholar
  3. 3.
    Saraste M, Koskenvuo J W, Mikkola Jet al. Technical achievement: transthoracic Doppler echocardiography can be used to detect LAD restenosis after coronary angioplasty. Clin Physiol, 2000, 20: 428PubMedCrossRefGoogle Scholar
  4. 4.
    Caiati C, Aragona P, Iliceto Set al. Improved Doppler detection of proximal left anterior descending coronary artery stenosis after intravenous injection of a lung-crossing contrast agent: A transesophageal Doppler echocardiographic study. J Am Coll Cardiol, 1996, 27: 1413PubMedCrossRefGoogle Scholar
  5. 5.
    Deng Y B, Wang X F, Li C L. A new noninvasive method for evaluation of coronary endothelial function in hypertensive patients based on change in diameter of the left main coronary artery induced by cold pressor test using echocardiography. Clin Cardiol, 2001, 24: 291PubMedCrossRefGoogle Scholar
  6. 6.
    Krzanowski M, Bodzon W, Dimitrow P P. Imaging of all three coronary arteries by transthoracic echocardiography: An illustrated guide. Cardiovasc Ultrasound, 2003, 17: 16CrossRefGoogle Scholar
  7. 7.
    Krzanowski M, Bodzon W, Brzostek Tet al. Value of transthoracic echocardiography for the detection of high-grade coronary artery stenosis: prospective evaluation in 50 consecutive patients scheduled for coronary angiography. J Am Soc Echocardiogr, 2000, 13: 1091PubMedCrossRefGoogle Scholar
  8. 8.
    Albertal M, Regar E, Piek J Jet al. Value of coronary stenotic flow velocity acceleration on the prediction of long-term improvement in functional status after angioplasty. Am Heart J, 2001, 142: 81PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Chen Bin
    • 1
  • Deng Youbin
    • 1
  • Yang Haoyi
    • 1
  • Ruan Yanfei
    • 1
  • Chang Qing
    • 1
  • Bi Xiaojun
    • 1
  • Wang Hongying
    • 1
  1. 1.Department of Medical Ultrasound, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina

Personalised recommendations