Coronary collaterals by transthoracic echocardiography in coronary artery disease

Anjaneyulu, Anne; Johann, Christopher; Raghava, Raju P; Kumar, Darren; Chennapragada, Sridevi; Soma, Raju B; Krishnam, Raju P; Rajagopala, Raju A

doi:10.1016/j.echo.2003.12.019

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…In accordance with earlier studies [10,18], finding elongated epicardial or intramyocardial vessels with enhanced, typically mosaic-patterned flow was considered as collateral flow to an occluded coronary artery (Figure 5A).…”

Section: Methodssupporting

confidence: 80%

“…Though transthoracic Doppler echocardiography (TTE) cannot give a complete and panoramic view of the coronary arteries and collateral vessels, various findings by TTE are shown to diagnose occlusions and collaterals with a high degree of accuracy [10,13-18]. Using TTE, a coronary occlusion may be detected by demonstrating retrograde flow in the arterial trunk, left circumflex marginal branches (CxMb), or septal perforating branches [10,13-17].…”

Section: Introductionmentioning

confidence: 99%

“…Using TTE, a coronary occlusion may be detected by demonstrating retrograde flow in the arterial trunk, left circumflex marginal branches (CxMb), or septal perforating branches [10,13-17]. Enhanced flow in elongated epicardial or intramyocardial vessels has been shown to represent collateral flow to an occluded coronary artery [10,18]. Finally, accelerated anterograde flow velocities in septal perforating branches have been proposed to indicate collateral flow to an occluded artery [17,18].…”

Section: Introductionmentioning

confidence: 99%

“…Enhanced flow in elongated epicardial or intramyocardial vessels has been shown to represent collateral flow to an occluded coronary artery [10,18]. Finally, accelerated anterograde flow velocities in septal perforating branches have been proposed to indicate collateral flow to an occluded artery [17,18]. However, these TTE studies are few, and most studies have in limited patient cohorts used only one or two parameters to detect coronary occlusions and collateral flow.…”

Section: Introductionmentioning

confidence: 99%

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Coronary artery occlusions diagnosed by transthoracic Doppler

Vegsundvåg

Holte

Wiseth

et al. 2014

Cardiovasc Ultrasound

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BackgroundOur aim was to assess whether anterograde flow velocities in septal perforating branches could identify an occluded contralateral coronary artery, and to assess the feasibility and accuracy of diagnosing occlusions in the three main coronary arteries by the combined use of several noninvasive parameters indicating collateral flow.MethodsA total of 108 patients scheduled for coronary angiography because of chest pain or acute coronary syndromes were studied using transthoracic Doppler echocardiography.ResultsAnterograde peak diastolic flow velocities (pDV) in septal perforating branches were higher in patients with angiographic occluded contralateral artery compared with corresponding velocities in patients without significant disease in the contralateral artery (0.80 ± 0.31 m/sec versus 0.37 ± 0.13 m/sec, p < 0.001). Receiver operating characteristic curve showed pDV ≥ 0.57 m/sec to be the optimal cutoff value to identify occluded contralateral artery, with a sensitivity of 79% and a specificity of 69%. Demonstration of at least one positive parameter (retrograde flow in main coronary arteries, reversed flow in septal perforating and left circumflex marginal branches, pDV ≥ 0.57 m/sec, or demonstration of other epicardial or intramyocardial collaterals) indicating collateral flow to an occluded main coronary artery had sensitivity, specificity, positive and negative predictive value of 89%, 94%, 63%, and 99%, respectively, for detection of a coronary occlusion. With this combined use of several parameters, 25 of 28 coronary occlusions were identified.ConclusionsBy investigating several parameters indicating collateral flow, we were able to identify most of the main coronary occlusions in the patient cohort. Furthermore, our study demonstrated that coronary artery occlusions may result in complex and diverging coronary pathophysiology depending on which coronary artery segment is occluded and the extent of accompanying coronary artery disease.Trial registrationClinicalTrials.gov number NTC00281346.

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Section: Methodssupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Coronary artery occlusions diagnosed by transthoracic Doppler

Vegsundvåg

Holte

Wiseth

et al. 2014

Cardiovasc Ultrasound

View full text Add to dashboard Cite

show abstract

“…The flow velocity in the proximal segments of normal coronary arteries is typically 20–30 cm/sec, 2 but was 1.4 m/sec in this patient's collateral artery (Fig. 3), consistent with a prior report of high collateral flow velocity 3 . In fact, based on this finding, proximal LAD occlusion was suspected prior to its documentation by angiography.…”

supporting

confidence: 88%