Coronary Flow Velocity Reserve Measurement in Three Major Coronary Arteries Using Transthoracic Doppler Echocardiography

Murata, Eri; Hozumi, Takeshi; Matsumura, Yoshiki; Fujimoto, Kohei; Sugioka, Kenichi; Takemoto, Yasuhiko; Watanabe, Hiroyuki; Yamagishi, Hiroyuki; Yoshiyama, Minoru; Itoh, Hiroshi; Yoshikawa, Junichi

doi:10.1111/j.1540-8175.2006.00206.x

Cited by 36 publications

(22 citation statements)

References 19 publications

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“…Finally, CFR was measured by TTDE method in the LAD alone, and the effect of RIC on circulation in other coronary vessels was not estimated. This was because the success rates in obtaining adequate coronary flow velocity in the LAD were higher than those in other coronary vessels 34. Concomitant measurement of CFR in an adjacent normal vessel may provide more mechanistic insights into the findings of this study.…”

Section: Discussionmentioning

confidence: 91%

Remote ischemic conditioning improves coronary microcirculation in healthy subjects and patients with heart failure

Kono¹,

Fukuda²,

Hanatani³

et al. 2014

DDDT

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BackgroundRemote ischemic conditioning (RIC) is a treatment modality that suppresses inflammation and improves endothelial function, which are factors involved in the pathogenesis of heart failure (HF) with reduced left ventricular ejection fraction. Coronary flow reserve (CFR) is a physiological index of coronary microcirculation and is noninvasively measured by transthoracic Doppler echocardiography (TTDE). This study aimed to investigate the effects of RIC on CFR in healthy subjects and patients with HF, through the assessment by TTDE.MethodsTen patients with HF with left ventricular ejection fraction of less than 40%, and ten healthy volunteers were enrolled in this study. RIC treatment was performed twice a day for 1 week. Our custom-made RIC device was programmed to automatically conduct 4 cycles of 5 minutes inflation and 5 minutes deflation of a blood pressure cuff to create intermittent arm ischemia. CFR measurements and laboratory tests were examined before, and after 1 week of RIC treatment.ResultsOne week of RIC treatment was well tolerated in both groups. RIC treatment increased CFR from 4.0±0.9 to 4.6±1.3 (mean ± standard deviation) in healthy subjects (P=0.02), and from 1.9±0.4 to 2.3±0.7 in patients with HF (P=0.03), respectively. Systolic blood pressure in healthy subjects, and heart rate in HF patients decreased after RIC treatment (both P<0.01).ConclusionThis study demonstrated that a 1 week course of RIC treatment improved coronary microcirculation in healthy subjects and patients with HF associated with reduced left ventricular ejection fraction.

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Section: Discussionmentioning

confidence: 91%

Remote ischemic conditioning improves coronary microcirculation in healthy subjects and patients with heart failure

Kono¹,

Fukuda²,

Hanatani³

et al. 2014

DDDT

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show abstract

“…LCx distal CFR recording has been reported until now in few papers only [17-19] with a described feasibility of about 80%; however, a comparison with DW method is still lacking.…”

Section: Discussionmentioning

confidence: 99%

“…However, only few papers concerning the distal Left Circumflex coronary artery (LCx) have been published [17-19]. Technical difficulties may pose feasibility challenges to LCx recording like the supposed lack of a reference structure to identify the position of the distal branches of LCx on the lateral left ventricle wall or the poor lateral resolution of current equipments accounted for.…”

Section: Introductionmentioning

confidence: 99%

Distal left circumflex coronary artery flow reserve recorded by transthoracic Doppler echocardiography: a comparison with Doppler-wire

Auriti

Pristipino²,

Cianfrocca

et al. 2007

Cardiovasc Ultrasound

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BackgroundCoronary flow reserve (CFR) recording by means of transthoracic echocardiography (TTDE) in all the main distal coronary arteries is a challenge for advanced echocardiography. Validation studies of TTDE versus Doppler-wire (DW) recordings are available for Left Anterior Descending artery (LAD) and the Posterior Descending coronary artery (PD), but lacking for the more technically challenging Left Circumflex coronary artery (LCx).AimTo evaluate the reliability of TTDE in assessing CFR in LCx when compared to the intracoronary Doppler flow-wire gold standard.Methodswe evaluated 5 patients (age = 60 ± 9 years, 5 males) on LCx by TTDE and invasive CFR assessment. TTDE recording was performed using a low-frequency probe, with a four-chamber as a guiding 2D view. The 2 tests were performed on different days and in random order within 48 hours in a blind fashion. Vasodilator stimulus was adenosine, intravenously (140 γ/kg/min × 3–6 min) for TTDE and intracoronary (40 γ bolus) for DW recordings.ResultsCFR values on LCx ranged from 1.9 to 2.8 for DW, and from 2.0 to 3.0 for TTDE, with an overall correlation of R = 0,85 (p = 0,06); normal (CFR > 2.5) or abnormal (CFR < 2.5) value was concordantly identified by the 2 techniques in 4 out 5 cases (80%).ConclusionCFR of LCx artery can be obtained noninvasively with TTDE.

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“…Using an apical, 2-chambers echocardiographic view is also possible to check the posterior interventricular artery: the feasibility of this examination is clearly worse, in this case, due to the over breathing induced by adenosine and for the use of common transducers (while for the anterior descending artery is already mandatory the use of dedicated probes). The overall feasibility of the TTE-CFR assessment is quite good in all the main epicardial coronary arteries: 98% for the anterior descending artery; 81% for the posterior interventricular one; 73% for the circumflex 13 .…”

mentioning

confidence: 94%

Coronary Flow: From Pathophysiology to Clinical Noninvasive Evaluation

Bartolomucci¹,

Cipriani²,

Deluca³

2012

Coronary Artery Disease - Current Concepts in Epidemiology, Pathophysiology, Diagnostics and Treatment

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Coronary Flow Velocity Reserve Measurement in Three Major Coronary Arteries Using Transthoracic Doppler Echocardiography

Abstract: Noninvasive CFVR measurement by TTDE may be useful for detecting myocardial ischemia, as well as for identifying ischemic territories in the clinical setting.

Cited by 36 publications

References 19 publications

Remote ischemic conditioning improves coronary microcirculation in healthy subjects and patients with heart failure

Remote ischemic conditioning improves coronary microcirculation in healthy subjects and patients with heart failure

Distal left circumflex coronary artery flow reserve recorded by transthoracic Doppler echocardiography: a comparison with Doppler-wire

Coronary Flow: From Pathophysiology to Clinical Noninvasive Evaluation

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