Can We Finally Measure Blood Flow Velocity all Through the Coronary Artery Three by Transthoracic Doppler Echocardiography in Patients with Myocardial Hypertrophy?

2005 ◽  
Vol 18 (12) ◽  
pp. 1464-1466 ◽  
Author(s):  
Cesare de Gregorio
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Flow Velocity ◽  
Doppler Echocardiography ◽  
Blood Flow Velocity ◽  
Myocardial Hypertrophy ◽  
Transthoracic Doppler Echocardiography ◽  
Measure Blood Flow

scholarly journals Role of transmittal blood flow velocity by doppler echocardiography in the evaluation of coronary artery disease

1990 ◽  
Vol 13 (2) ◽  
pp. 108-114 ◽  
Author(s):  
C. Brunckhorst ◽  
H. W. Lange ◽  
W. Aschenberg ◽  
W. Rehpenning ◽  
W. Bleifeld
Keyword(s):  
Coronary Artery Disease ◽  
Blood Flow ◽  
Coronary Artery ◽  
Flow Velocity ◽  
Doppler Echocardiography ◽  
Blood Flow Velocity ◽  
Artery Disease

Association between coronary lesion severity and distal microvascular resistance in patients with coronary artery disease

2003 ◽  
Vol 285 (5) ◽  
pp. H2194-H2200 ◽  
Author(s):  
Steven A. J. Chamuleau ◽  
Maria Siebes ◽  
Martijn Meuwissen ◽  
Karel T. Koch ◽  
Jos A. E. Spaan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Blood Flow ◽  
Coronary Artery ◽  
Flow Velocity ◽  
Blood Flow Velocity ◽  
Guide Wire ◽  
Coronary Lesion ◽  
Artery Disease ◽  
Microvascular Resistance ◽  
Lesion Severity

Homogeneity of microvascular resistance in different perfusion areas of the same heart is generally assumed. We investigated the effect of the severity of an epicardial stenosis on microvascular resistance in 27 patients with coronary artery disease and stable angina. All patients had an angiographically normal coronary artery, an artery with an intermediate lesion, and an artery with a severe lesion; the latter was treated with angioplasty. In each patient, distal blood flow velocity and pressure were measured during baseline and maximal hyperemia (induced by intracoronary adenosine) using a Doppler and pressure guide wire, respectively. The ratio of mean distal pressure to average peak blood flow velocity was used as an index for the microvascular resistance (MRv). Within patients, the hyperemic MRv was higher in arteries with more severe stenosis ( P = 0.021). After percutaneous transluminal coronary angioplasty (PTCA), the hyperemic MRv decreased (pre-PTCA, 2.6 vs. post-PTCA, 1.9 mmHg·cm–1s–1, P < 0.01) toward the value of the reference artery (1.7 mmHg·cm–1s–1; P = 0.67). We conclude that there is a positive association between coronary lesion severity and variability of distal microvascular resistance that normalizes after angioplasty. This study challenges the concept of uniform distribution of hyperemic MRv that is relevant for the interpretation of both noninvasive and invasive diagnostic tests.

Computer Analysis of Coronary Doppler Flow Velocity

2008 ◽  
pp. 281-289
Author(s):  
Valentina Magagnin ◽  
Maurizio Turiel ◽  
Sergio Cerutti ◽  
Luigi Delfino ◽  
Enrico Caiani
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Flow Velocity ◽  
Coronary Blood Flow ◽  
Doppler Echocardiography ◽  
Coronary Flow ◽  
Connective Tissue Diseases ◽  
Doppler Flow ◽  
Intracoronary Doppler ◽  
Artery Disease

The coronary flow reserve (CFR) represents an important functional parameter to assess epicardial coronary stenosis and to evaluate the integrity of coronary microcirculation (Kern, 2000; Sadamatsu, Tashiro, Maehira, & Yamamoto, 2000). CFR can be measured, during adenosine or dipyridamole infusion, as the ratio of maximal (pharmacologically stimulated) to baseline (resting) diastolic coronary blood flow peak. Even in absence of stenosis in epicardial coronary artery, the CFR may be decreased when coronary microvascular circulation is compromised by arterial hypertension with or without left ventricular hypertrophy, diabetes mellitus, hypercholesterolemia, syndrome X, hypertrophic cardiomyopathy, and connective tissue diseases (Dimitrow, 2003; Strauer, Motz, Vogt, & Schwartzkopff, 1997). Several methods have been established for measuring CFR: invasive (intracoronary Doppler flow wire) (Caiati, Montaldo, Zedda, Bina, & Iliceto, 1999b; Lethen, Tries, Brechtken, Kersting, & Lambertz, 2003a; Lethen, Tries, Kersting, & Lambertz, 2003b), semi-invasive and scarcely feasible (transesophageal Doppler echocardiography) (Hirabayashi, Morita, Mizushige, Yamada, Ohmori, & Tanimoto, 1991; Iliceto, Marangelli, Memmola, & Rizzon, 1991; Lethen, Tries, Michel, & Lambertz, 2002; Redberg, Sobol, Chou, Malloy, Kumar, & Botvinick, 1995), or extremely expensive and scarcely available methods (PET, SPECT, MRI) (Caiati, Cioglia, Montaldo, Zedda, Rubini, & Pirisi, 1999a; Daimon, Watanabe, Yamagishi, Muro, Akioka, & Hirata, 2001; Koskenvuo, Saraste, Niemi, Knuuti, Sakuma, & Toikka, 2003; Laubenbacher, Rothley, Sitomer, Beanlands, Sawada, & Sutor, 1993; Picano, Parodi, Lattanzi, Sambuceti, Andrade, & Marzullo, 1994; Saraste, Koskenvuo, Knuuti, Toikka, Laine, & Niemi, 2001; Williams, Mullani, Jansen, & Anderson, 1994), thus their clinical use is limited (Dimitrow, 2003). In addition, PET and intracoronary Doppler flow wire involve radiation exposure, with inherent risk, environmental impact, and biohazard connected with use of ionizing testing (Picano, 2003a). In the last decade, the development of new ultrasound equipments and probes has made possible the noninvasive evaluation of coronary blood velocity by Doppler echocardiography, using a transthoracic approach. In this way, the peak diastolic coronary flow velocity reserve (CFVR) can be estimated as the ratio of the maximal (pharmacologically stimulated) to baseline (resting) diastolic coronary blood flow velocity peak measured from the Doppler tracings. Several studies have shown that peak diastolic CFVR, computed in the distal portion of the left anterior descending (LAD) coronary artery, correlates with CFR obtained by more invasive techniques. This provided a reliable and non invasive tool for the diagnosis of LAD coronary artery disease (Caiati et al., 1999b; Caiati, Montaldo, Zedda, Montisci, Ruscazio, & Lai, 1999c; Hozumi, Yoshida, Akasaka, Asami, Ogata, & Takagi, 1998; Koskenvuo et al., 2003; Saraste et al., 2001).

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