Acceleration Time of Systolic Coronary Flow Velocity to Diagnose Coronary Stenosis in Patients with Microvascular Dysfunction

Takemoto, Kazushi; Hirata, Kumiko; Wada, Nozomi; Shiono, Yasutsugu; Komukai, Kenichi; Tanimoto, Takashi; Ino, Yasushi; Kitabata, Hironori; Takarada, Shigeho; Nakamura, Nobuo; Kubo, Takashi; Tanaka, Atsushi; Imanishi, Toshio

doi:10.1016/j.echo.2013.10.013

Cited by 5 publications

(3 citation statements)

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“…Coronary flow velocity reserve (CFVR) is dependent on the combined effects of epicardial coronary stenosis and microvascular dysfunction [ 3 , 12 , 13 ]. For coronary flow study, we administered adenosine triphosphate (0.14 mg/kg/min) intravenously for 2 min after the baseline coronary flow velocity (CFV) of the LAD was recorded.…”

Section: Methodsmentioning

confidence: 99%

“…CFVs were recorded at the baseline and during hyperemia and averaged over five cardiac cycles. CFVR was defined as the ratio of mean diastolic CFV during hyperemia to that at the baseline [ 12 , 13 ]. All measurements were performed by the experienced investigator who was blinded to all other data using EchoPAC 6.1; GE Healthcare, Horten, Norway.…”

Section: Methodsmentioning

confidence: 99%

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Effect of Erythropoietin Administration on Myocardial Viability and Coronary Microvascular Dysfunction in Anterior Acute Myocardial Infarction: Randomized Controlled Trial in the Japanese Population

2018

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IntroductionCardioprotective effects of erythropoietin (EPO) on infarcted myocardium in acute myocardial infarction (AMI) patients have been inconclusive. This study aimed to assess the effect of EPO administration on coronary microvascular dysfunction (CMD) and myocardial viability in anterior AMI. We also evaluated the serial changes in CMD and cardiac remodeling in these patients.MethodsPatients with a successful percutaneous coronary intervention (PCI) for the first anterior AMI were randomly assigned to two groups (EPO and control groups), and given single-dose intravenous administration of recombinant human EPO (12,000 IU) or saline after PCI. Delayed-enhanced cardiac magnetic resonance imaging was performed at 1 week after AMI to assess the average of transmural extent of infarction and infarct size. Coronary flow velocity reserve (CFVR) of the left anterior descending coronary artery was measured by Doppler echocardiography at 1 week, 1 month, and 8 months after AMI. All patients underwent clinical follow-up for the assessment of cardiac remodeling.ResultsSixty-one patients (EPO 32, control 29) were eligible for analysis. EPO group (2.4 ± 1.2) had a tendency of smaller transmural extent of infarction than that of control group (2.9 ± 1.1; p = 0.063). CFVR-8 months improved significantly in EPO group (2.9 ± 0.6) compared to control group (2.6 ± 0.5; p = 0.04). Left atrial (LA) volume − 8 months was significantly lower in EPO group (47 ± 11) than those of control group (65 ± 20; p = 0.004).ConclusionsA single medium dose of EPO could have a favorable effect on CMD and LA remodeling in the chronic phase of anterior AMI.Trial RegistrationThe institutional ethics committee of Wakayama Medical University, identifier, 1125.Electronic supplementary materialThe online version of this article (10.1007/s40119-018-0122-1) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Effect of Erythropoietin Administration on Myocardial Viability and Coronary Microvascular Dysfunction in Anterior Acute Myocardial Infarction: Randomized Controlled Trial in the Japanese Population

2018

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“…Thus, the evaluation of ≥50% stenosis is more meaningful, but there is no relevant literature report. In addition, several studies found that AT was an useful ultrasound parameter to predict internal carotid artery stenosis, lower extremity peripheral artery stenosis, renal artery stenosis, hepatic artery stenosis and coronary artery stenosis (32)(33)(34)(35)(36). However, its efficacy in evaluating SA stenosis is unclear.…”

Section: Ultrasound Parameters In Previous Studiesmentioning

confidence: 99%

Color Doppler Ultrasonography for the Evaluation of Subclavian Artery Stenosis

et al. 2022

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BackgroundIt is of great significance to evaluate symptomatic subclavian artery (SA) stenosis by color Doppler ultrasonography. More than 50% SA stenosis may induce symptoms. Currently, there is a paucity of published literature and lack of practitioner consensus for how ultrasonic findings should be interpreted in patients with SA stenosis.ObjectiveThe study aimed to prospectively evaluate SA stenosis using color Doppler ultrasonography, with digital subtraction angiography as a reference. Moreover, we aimed to determine the optimal thresholds to predict SA stenosis (≥50%).MethodsA total of 423 SAs from 234 patients with normal or stenotic lumen were enrolled. The peak systolic velocity (PSV) and acceleration time at the stenotic and distal segments of the SA, peak reversed velocity of the vertebral artery, and waveforms of the stenotic SA, distal SA, and vertebral artery were recorded. The ratios of stenotic PSV to distal PSV (PSVr) and distal AT to stenotic AT were also calculated. The optimal cutoff values were determined using receiver operating characteristic analysis.ResultsAll ultrasonic parameters were significantly correlated with the degree of SA stenosis, whereas PSV (r = 0.624, P < 0.001), PSVr (r = 0.654, P < 0.001) and VA waveform change (r = 0.631, P < 0.001) had the strongest correlation with SA stenosis. The optimal cutoff values were as follows: PSV ≥ 230 cm/s and PSVr ≥ 2.2 to predict ≥ 50% stenosis, and PSV ≥ 340 cm/s and PSVr ≥ 3.0 to predict ≥ 70% stenosis.ConclusionsSymptomatic patients with the ultrasonic parameters of PSV ≥ 230 cm/s and PSVr ≥ 2.2 need to be considered for further verification by computed tomographic angiography or magnetic resonance angiography, or by digital subtraction angiography with a view to percutaneous transluminal angioplasty/stent implantation in the same session. The recommended graded cutoff values can help in long-term management of patients with SA stenosis.

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Sonography of Coronary Arteries

Becher

Helfen

2019

Contrast Echocardiography

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Acceleration Time of Systolic Coronary Flow Velocity to Diagnose Coronary Stenosis in Patients with Microvascular Dysfunction

Cited by 5 publications

References 34 publications

Effect of Erythropoietin Administration on Myocardial Viability and Coronary Microvascular Dysfunction in Anterior Acute Myocardial Infarction: Randomized Controlled Trial in the Japanese Population

Effect of Erythropoietin Administration on Myocardial Viability and Coronary Microvascular Dysfunction in Anterior Acute Myocardial Infarction: Randomized Controlled Trial in the Japanese Population

Color Doppler Ultrasonography for the Evaluation of Subclavian Artery Stenosis

Sonography of Coronary Arteries

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