Physiologic assessment of coronary artery stenosis by coronary flow reserve measurements with transthoracic doppler echocardiography: comparison with exercise thallium-201 single-photon emission computed tomography

Daimon, Masao; Watanabe, Hiroyuki; Yamagishi, Hiroyuki; Muro, Takashi; Akioka, Kaname; Hirata, Kumiko; Takeuchi, Kazuhide; Yoshikawa, Junichi

doi:10.1016/s0735-1097(01)01167-6

Cited by 111 publications

(72 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For example, in the presence of right ACAOS, a normally originating prominent conal branch could be misinterpreted as a normally originating RCA. Some operators have recently reported a new capacity to evaluate anterior coronary vessels for severity of obstruction by means of contrast-enhanced, color-guided, pulsed-wave Doppler-flow interrogation during transthoracic echocardiography [16,17]; this development may be of interest with respect to future applications in ACAOS.…”

Section: Echocardiographymentioning

confidence: 99%

Newer concepts for imaging anomalous aortic origin of the coronary arteries in adults

Angelini

Flamm

2007

Cathet Cardio Intervent

112

View full text Add to dashboard Cite

Of the different kinds of coronary anomalies observed in adults, anomalous origin of a coronary artery from the opposite sinus of Valsalva with an "interarterial" course (ACAOS) entails a high risk of clinical consequences related to the intramural course of the ectopic coronary artery. We review current imaging modalities for differentiating this condition from generally benign coronary anomalies and for quantifying the severity of individual cases. For identifying ACAOS, noninvasive modalities (echocardiography, computed tomographic angiography, and coronary magnetic resonance angiography) are preferred: the favored modalities are transthoracic echocardiography in children and multidetector computed tomography in adults. For evaluating the pathophysiologic mechanisms of ischemia in ACAOS and subclassifying the severity of individual forms, coronary intravascular ultrasonography provides enhanced temporal and spatial resolution. The critical quantifiable features of the coronary anatomy in ACAOS seem to be hypoplasia, lateral compression at the level of the intramural course, and possibly exercise-related further narrowing of the proximal ectopic segment. Definitive guidelines are being developed for the optimal workup and treatment of ACAOS.

show abstract

Section: Echocardiographymentioning

confidence: 99%

Newer concepts for imaging anomalous aortic origin of the coronary arteries in adults

Angelini

Flamm

2007

Cathet Cardio Intervent

112

View full text Add to dashboard Cite

show abstract

“…Many more confounding factors may arise: the main one is certainly the microcirculatory dysfunction. TTE-CFR can be used in clinical practice to collect data comparable with that from invasive tests 30 . CFR normality cutoff is >2.…”

Section: Coronary Flow Reserve and Epicardial Coronary Stenosesmentioning

confidence: 99%

Coronary Flow: From Pathophysiology to Clinical Noninvasive Evaluation

Bartolomucci¹,

Cipriani²,

Deluca³

2012

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

View full text Add to dashboard Cite

“…Several recent studies have shown that coronary flow velocity (CFV) in the distal part of the left anterior descending coronary artery (LAD) can be successfully measured by transthoracic Doppler echocardiography (TTDE), and the measurement of coronary flow velocity reserve (CFVR) with adenosine or dipyridamole has been shown to be a useful index for detecting functionally significant LAD stenosis. [10][11][12] method also may be useful for the serial assessment of CFVR in the same patients. It is uncertain whether or not coronary microvascular dysfunction in diabetic patients is irreversible with hypoglycemic therapy.…”

mentioning

confidence: 99%

Optimum Hypoglycemic Therapy can Improve Coronary Flow Velocity Reserve in Diabetic Patients-Demonstration by Transthoracic Doppler Echocardiography-

Miyazaki

Takeuchi

Yoshitani

et al. 2003

Circ J

Self Cite

View full text Add to dashboard Cite

iabetes mellitus (DM) is a major independent risk factor for coronary artery disease 1,2 and such patients show not only atherosclerosis of the major epicardial coronary arteries, but also microvascular dysfunction in accordance with disease severity and duration. 3 The progression of abnormalities in the coronary circulation is associated with reduced coronary flow reserve (CFR), and may produce myocardial ischemia, even in the absence of angiographically significant coronary artery stenosis. 4,5 Hyperglycemia is known to be a pivotal factor for the development of vascular abnormalities, which might be account for the reduction in CFR in diabetic patients. 6,8,9 The current methods for measuring CFR are only available in the cardiac catheterization laboratory (eg, Doppler guidewire) or a very few cardiovascular centers (eg, positron emission tomography), and thus are not used for the general diabetic population. Several recent studies have shown that coronary flow velocity (CFV) in the distal part of the left anterior descending coronary artery (LAD) can be successfully measured by transthoracic Doppler echocardiography (TTDE), and the measurement of coronary flow velocity reserve (CFVR) with adenosine or dipyridamole has been shown to be a useful index for detecting functionally significant LAD stenosis. [10][11][12] method also may be useful for the serial assessment of CFVR in the same patients. It is uncertain whether or not coronary microvascular dysfunction in diabetic patients is irreversible with hypoglycemic therapy. We hypothesized that the elimination of hyperglycemia would accompany the improvement of CFVR. To determine this, we performed the serial assessment of CFVR by TTDE before and after intensive antidiabetic treatment in poorly controlled diabetic patients. Methods PatientsThe study group comprised 54 consecutive poorly controlled type II diabetic patients who on admission to hospital had required intensive antidiabetic treatment for their high blood glucose concentration. Poorly controlled diabetes was defined as a fasting blood glucose (FBG) concentration >150 mg/dl. None of the patients had a definite history of coronary artery disease or wall motion abnormality on 2-dimensional echocardiography. Their mean age was 62±12 years (30 men, 24 women). Twelve patients had new onset of diabetes and the other 42 had a history of antidiabetic treatment in the outpatient clinic for a mean of 8±9 years. Seventeen type II diabetic patients with well controlled blood glucose (FBG <150 mg/dl) who were admitted to hospital for other reasons served as the control group (mean age, 63±11 years; 10 men, 7 women). ProtocolThe ethics committee of the hospital approved the study protocol, and informed consent was obtained from all Circ J 2003; 67: 945 -950 (Received November 18, 2002; revised manuscript received August 11, 2003; accepted August 20, 2003

show abstract

Physiologic assessment of coronary artery stenosis by coronary flow reserve measurements with transthoracic doppler echocardiography: comparison with exercise thallium-201 single-photon emission computed tomography

Abstract: Noninvasive measurement of CFR by TTDE provides data equivalent to those obtained by Tl-201-SPECT for physiologic estimation of the severity of LAD stenosis.

Cited by 111 publications

References 25 publications

Newer concepts for imaging anomalous aortic origin of the coronary arteries in adults

Newer concepts for imaging anomalous aortic origin of the coronary arteries in adults

Coronary Flow: From Pathophysiology to Clinical Noninvasive Evaluation

Optimum Hypoglycemic Therapy can Improve Coronary Flow Velocity Reserve in Diabetic Patients-Demonstration by Transthoracic Doppler Echocardiography-

Contact Info

Product

Resources

About