Evaluation of coronary blood flow by transthoracic Doppler echocardiography

虽然它是。经胸超声心动图很难看到心外膜冠状动脉血流，近年来超声仪器的发展使心外膜动脉血流可视化成为可能。探讨红杉系统经胸多普勒超声心动图对冠状动脉血流的检出率及对冠状动脉狭窄的诊断价值。高灵敏度的彩色和脉冲多普勒超声不仅可以有效地检测左冠状动脉前降支（LAD），还可以检测左旋动脉近端。经胸多普勒超声心动图测量LAD的冠状动脉血流储备（CFR）与有创法测量CFR的准确性相当（r=0.87, p<0.0001）。采用彩色多普勒引导脉冲多普勒进行LAD冠状动脉血流定位，并根据最高舒张平均速度（HDMV）和最低舒张平均速度（LDMV） （DMVR = HDMV/ LDMV）计算LAD的舒张平均速度比（DMVR）。当DMVR为2.0及以上视为异常高值时，诊断狭窄病变伴50%直径狭窄（DS）及以上，敏感性93%，特异性93%。经胸彩色多普勒超声心动图显示从右冠状动脉到左冠状动脉的良好侧支冠状动脉血流。高灵敏度的经胸多普勒超声心动图对评估非。有创性、准确的冠状动脉狭窄。

Although it was. difficult to visualize epicardia1 coronary artery blood by transthoracic echocardiography, recent development of ultrasound instrument enable to visualize epicardial artery flow. We investigated the detection rate oLthe coronary artery blood flow and studied the diagnostic efficacy of coronary artery stenosis by transthoracic Doppler echocardiography using Sequoia system.The highly sensitive color and pulsed Doppler echo allowed efficient detection not only of the left anterior descending coronary artery (LAD), but also the proximal portion of the left circumflex artery. It was found that the coronary blood flow reserve (CFR) of LAD measured by transthoracic Doppler echocardiography was comparable in accuracy with CFR measured by invasive methods (r=0.87, p<0.0001).Coronary flow mapping in LAD was performed by the color Doppler-guided pulsed Doppler and diastolic mean velocity ratio (DMVR) in LAD was calculated from highest diastolic mean velocity (HDMV) and lowest diastolic mean velocity (LDMV) (DMVR = HDMV/ LDMV). When DMVR was 2.0 or more which was regarded as an abnormally high value, stenotic lesion with 50% diameter stenosis (DS) or more DS was diagnosed with 93% sensitivity and 93 % specificity.The good collateral coronary blood flow through the septal branches from right coronary artery to LAD was visualized by transthoracic color Doppler echocardiography.Highly sensitive transthoracic Doppler echocardiography was very useful to evaluate non.invasively and accurately coronary stenosis.