Background Several recent studies have reported the opportunity to diagnose significant narrowing of the coronary arteries without stress testing using local flow acceleration. Purpose To define how often patients with increased coronary flow velocities at rest (≥ 0.70 m/s) have a positive exercise echocardiography test. Material and Methods A total of 150 patients scheduled for exercise echocardiography were studied using transthoracic Doppler echocardiography in order to assess coronary artery flow velocity before exercise. Pulsed wave Doppler registered blood flow velocity placed on the color signal. The maximal diastolic velocity of coronary flow was measured. Results Of participants, 16% had a velocity of more than 0.70 m/s in the left main/proximal left anterior/proximal left circumflex arteries (LM/pLAD). A significant correlation was observed between the value of the maximal velocity in LM/pLAD and the ejection fraction at the peak of exercise ( r ≈ -0.39, P < 0.0001); between the value of the maximal velocity in LM/pLAD and index of wall motion abnormalities (IWMA) at the peak of exercise ( r ≈ 0.44, P < 0.0001); and between the value of the maximal velocity in LM/pLAD and dIWMA ( r ≈ 0.41, P < 0.0001). Afterwards, severe ischemia in stress echocardiography tests was observed in this group. The average IWMA of these tests was found to be 2.3. Sixty-two angiograms were available for comparison with Doppler data. Conclusion There is a significant correlation between the value of the maximal velocity in LM/pLAD/pLCx at rest and the severity of wall motion abnormalities during exercise tests.
Purpose. The aim of our study was to non-invasively investigate the parameters of coronary blood flow during exercise in patients with arterial hypertension. Materials and Methods. We enrolled 144 patients with arterial hypertension. All patients performed supine bicycle symptoms-limited tests. Throughout the exercise, the diastolic peaks of coronary flow velocity in left anterior descending artery (LAD) were measured. The values of diastolic velocity before and at maximal exercise, coronary flow velocity reserve (CFVR) and difference between peak and rest velocities were calculated offline. The control group consisted of 145 healthy persons. Results. The rest blood flow velocity in LAD was 33.0±8.4 cm/s, the peak velocity in LAD was 80.3±16.5 cm/s, difference of velocities was 48.2±13.9 cm/s, CFVR was 2.55±0.56. Women and men were comparable in velocity parameters during exercise test. There was no significant correlation between mass/index of left ventricle mass and velocity data in LAD. Hypertensive patients were comparable in investigated coronary artery flow parameters with healthy group. Conclusions. During supine bicycle tests, the patients with arterial hypertension have a similar coronary artery flow velocity profile with healthy persons.
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