Coronary flow velocity reserve measurement in three major coronary arteries using transthoracic doppler echocardiography
Coronary flow velocity reserve measurement in three major coronary arteries using transthoracic doppler echocardiography
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DOI：
10.1111/j.1540-8175.2006.00206.x
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发表时间：
2006-04-01
影响因子：
1.5
通讯作者：
Yoshikawa, J
中科院分区：
文献类型：
--
作者：
Murata, E;Hozumi, T;Yoshikawa, J
背景：据报道，通过经胸多普勒超声心动图（TTDE）测量冠状动脉血流速度储备（CFVR）可用于无创评估显着冠状动脉狭窄或心肌缺血。本研究的目的是评估该方法在临床环境中检测三种主要冠状动脉心肌缺血的价值。方法：我们研究了 89 名因胸痛转诊至我们门诊的连续患者。我们使用 TTDE 测量了三个主要冠状动脉的 CFVR。我们将至少一根血管中 CFVR < 2.0 定义为心肌缺血阳性。 CFVR 测量检测心肌缺血的准确性是通过与运动铊 201 (Tl-201) 单光子发射计算机断层扫描 (SPECT) 作为参考标准进行比较来确定的。结果：89 名患者中有 87 名 (98%) 成功测量了至少一根血管的 CFVR。在任何冠状动脉区域中，至少一根冠状血管中 CFVR < 2.0 的敏感性和特异性分别为 86% 和 89%。在评估各冠状动脉区域的心肌缺血方面，左前降支、后降支和左旋支冠状动脉区域的 CFVR < 2.0 与 Tl-201 SPECT 的一致性分别为 95%、81% 和 73%。结论：通过 TTDE 进行无创 CFVR 测量可能有助于检测心肌缺血，以及在临床环境中识别缺血区域。
Background: Measurement of the coronary flow velocity reserve (CFVR) by transthoracic Doppler echocardiography (TTDE) has been reported to be useful for the noninvasive assessment of significant coronary artery stenosis or myocardial ischemia. The purpose of this study was to evaluate the value of this method in three major coronary arteries for detecting myocardial ischemia in the clinical setting. Methods: We studied 89 consecutive patients who were referred to our outpatient clinic because of chest pain. We measured CFVR using TTDE in three major coronary arteries. We defined CFVR < 2.0 in at least one vessel as being positive for myocardial ischemia. The accuracy of CFVR measurements for detecting myocardial ischemia was determined in comparison with exercise thallium-201 (Tl-201) single photon emission computed tomography (SPECT) as a reference standard. Results: CFVR in at least one vessel was successfully measured in 87 of 89 patients (98%). The sensitivity and specificity of CFVR < 2.0 in at least one coronary vessel, in any of the coronary territories, was 86% and 89%, respectively. In terms of assessing myocardial ischemia in each coronary artery territory, the agreement between CFVR < 2.0 and Tl-201 SPECT for the left anterior descending coronary artery, the posterior descending coronary artery, and the left circumflex coronary artery territories was 95%, 81%, and 73%, respectively. Conclusion: Noninvasive CFVR measurement by TTDE may be useful for detecting myocardial ischemia, as well as for identifying ischemic territories in the clinical setting.