Validation of a new noninvasive, method (contrast-enhanced transthoracic second harmonic echo Doppler) for the evaluation of coronary flow reserve - Comparison with intracoronary Doppler flow wire
Validation of a new noninvasive, method (contrast-enhanced transthoracic second harmonic echo Doppler) for the evaluation of coronary flow reserve - Comparison with intracoronary Doppler flow wire
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DOI：
10.1016/s0735-1097(99)00342-3
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发表时间：
1999-10-01
影响因子：
24
通讯作者：
Iliceto, S
中科院分区：
文献类型：
--
作者：
Caiati, C;Montaldo, C;Iliceto, S
目的：我们验证了一种新的无创方法（经胸二次谐波超声多普勒）评估的左冠状动脉前降支（LAD）冠状动脉血流储备（CFR）与冠状动脉内多普勒血流线评估的CFR相一致的假设。对比增强经胸二次谐波回波多普勒是一种新的无创检测LAD血流速度和血流储备的方法。然而，它尚未与金标准方法进行验证。方法对25例经多普勒血流丝评估LAD CFR的患者，采用经胸多普勒造影增强法记录LAD远端静息时和静脉滴注腺苷充血时的血流情况。5例患者分别在血管成形术前后评估两次CFR。结果静脉造影与二次谐波多普勒技术联合应用，评估冠状动脉血流储备的可行性为100%。两种方法的一致性很高。事实上，除5名患者外，所有患者两种CFR测量值之间的最大差异为0.38。总体而言，个体差异的预测（95%）区间为-0.69 ~ +0.72。CFR测量的重现性也很高。两种测量结果的一致性限（95%）为-0.32至+0.32。结论：经胸超声增强多普勒与谐波模式评估的LAD冠状动脉血流储备与多普勒血流丝CFR测量结果非常吻合。这种新的无创方法可以对LAD的CFR进行可行、可靠和可重复的评估。[J]中华医学会心脏科杂志，1999;32(4):1104 - 1104。
OBJECTIVES We tested the hypothesis that coronary flow reserve (CFR) in the left anterior descending coronary artery (LAD) as assessed by a new noninvasive method (contrast-enhanced transthoracic second harmonic echo Doppler) is in agreement with CFR measurements assessed by intracoronary Doppler flow wire.BACKGROUND Contrast-enhanced transthoracic second harmonic echo Doppler is a novel noninvasive method to detect blood flow velocity and reserve in the LAD. However, it has not yet been validated versus a gold-standard method.METHODS Twenty-five patients undergoing CFR assessment in the LAD by Doppler flow wire were also evaluated by contrast-enhanced transthoracic Doppler to record blood flow in the distal LAD at rest and during hyperemia obtained by adenosine IV infusion. In five patients CFR was evaluated twice (before and after angioplasty).RESULTS As a result of the combined use of IV contrast and second harmonic Doppler technology, feasibility in assessing coronary flow reserve equaled 100%. The agreement between the two methods was high. In fact, in all but five patients the maximum difference between the two CFR measurements was 0.38. Overall, the prediction (95%) interval of individual differences was -0.69 to +0.72. Reproducibility of CFR measurements was also high. The limits of the agreement (95%) between the two measurements were -0.32 to +0.32.CONCLUSIONS Coronary flow reserve in the LAD as assessed by contrast-enhanced transthoracic echo Doppler along with harmonic mode concurs very closely with Doppler flow wire CFR measurements. This new noninvasive method allows feasible, reliable and reproducible assessment of CFR in the LAD. (J Am Coll Cardiol 1999;34:1193-200) (C) 1999 by the American College of Cardiology.