Reduced coronary flow reserve in the coronary sinus is a predictor of hemodynamically significant stenoses of the left coronary artery territory

Vrublevsky, Alexander V.; Boshchenko, Alla A.; Карпов, Р. С.

doi:10.1016/j.euje.2003.12.002

Cited by 16 publications

(19 citation statements)

References 18 publications

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“…They are all in vivo studies using transesophageal and transthoracic Doppler echocardiography [10][11][12][13][14]17,18], and none of these studies provided the precise correlation between the coronary sinus flow and the coronary infusion. Compared with in vivo studies, our study had some possible advantages.…”

Section: Discussionmentioning

confidence: 99%

“…Although a large number of clinical and experimental studies have validated the efficiency of retrograde coronary sinus perfusion [3][4][5][6][7][8][9], the studies on the diagnostic performance of coronary sinus flow detected by Doppler echocardiography in coronary artery disease are not yet rich enough. Over the last decade, the coronary flow reserve in the coronary sinus has been used to diagnose severe coronary artery stenosis by transesophageal Doppler echocardiography due to inadequate visualization of the coronary arteries [10][11][12]. Recently, our studies showed that coronary sinus flow depicted by transthoracic Doppler echocardiography at rest can detect coronary artery stenosis in non-hypertensive [13], hypertensive [14], and diabetic hypertensive patients.…”

Section: Introductionmentioning

confidence: 95%

“…The velocity time integral (VTI, cm) were determined through digitized Doppler spectral envelops (fig 2b). The coronary sinus flow was calculated according to the formula: flow =π×D 2 /4×VTI, where π is the ratio of the circumference of a circle to its diameter, and D is the diameter of the coronary sinus [10]. The average value of three spectral and planimetric envelopes was used.…”

Section: Figmentioning

confidence: 99%

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Coronary sinus fow measured by pulsed Doppler ultrasound is a powerful indicator of coronary blood supply – a pig heart in vitro study.

Zheng

Hua³

2016

Med Ultrason

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Aims: To evaluate the correlation between the coronary sinus flow and the infusion volume in the coronaries and assess the performance of coronary sinus flow in predicting coronary artery occlusion in an isolated pig heart. Material and methods: The coronary sinus flow was measured in 16 isolated pig hearts by pulsed Doppler ultrasound. The correlation between the coronary sinus flow and the infusion volume in different coronary artery was analyzed, and the performance of coronary sinus flow in predicting different coronary artery occlusion was deducted. Results: There were no statistically significant differences between the coronary sinus flow and the infusion volume in different coronary artery (p>0.05). The correlations between the coronary sinus flow and the infusion volume in left anterior descending coronary artery (LAD), left circumflex coronary artery (LCX), LAD and LCX, and LAD, LCX and right coronary artery (RCA) were all higher than 0.85 (p<0.01), and those of RCA, LAD and RCA, and LCX and RCA were between 0.6 and 0.8 (p<0.05). The areas under the receiver operating characteristics curve (AUC) were all higher than 0.90 (p<0.05) in predicting any two coronaries occlusion (<50% and 100%) and three coronaries occlusion (<50%) with a >85% sensitivity and specificity. Excepting RCA mild occlusion (<50%), AUCs in predicting one coronary occlusion (<50% and 100%) were between 0.7 and 0.9, with >80% sensitivity and specificity. Conclusions: The coronary sinus flow measured by pulsed Doppler ultrasound can effectively and exactly reflect the infusion volume in coronaries, which is a powerful indicator of coronary blood supply.Keywords: coronary sinus flow, coronary artery infusion, Doppler ultrasound; isolated heart, pig Coronary sinus flow measured by pulsed Doppler ultrasound is a powerful indicator of coronary blood supply -a pig heart in vitro study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Section: Figmentioning

confidence: 99%

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Coronary sinus fow measured by pulsed Doppler ultrasound is a powerful indicator of coronary blood supply – a pig heart in vitro study.

Zheng

Hua³

2016

Med Ultrason

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“…4) Moreover, TEE can provide direct visualization through Doppler technique, 7) coronary arterial flow reserve, 8)9) and coronary sinus flow reserve. [10][11][12] This review focuses on TEE evaluation of thoracic aortic atherosclerosis and coronary atherosclerosis and details some of the data we have collected.…”

Section: )5)mentioning

confidence: 99%

Transesophageal Echocardiographic Evaluation of Atherosclerosis

Nishino

Tanouchi

2008

Korean Circ J

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Transesophageal echocardiography (TEE) is a promising method for evaluating thoracic aortic atherosclerosis and coronary atherosclerosis. The highest impact of TEE as a clinical tool is in searching for cardiac embolic sources in patients with stroke and atrial fibrillation and in conducting detailed evaluations in patients with valvular disease, especially those with mitral valvular disease. However, it is also clinically useful in the evaluation of thoracic aortic atherosclerosis and coronary atherosclerosis. TEE is capable of evaluating thoracic aortic atherosis (intima-media complex thickness) and sclerosis (stiffness parameter β) simultaneously. In addition, TEE can evaluate coronary atherosclerosis by non-invasively revealing narrowing or occlusion of the coronary arteries and providing information about coronary flow reserve. TEE imaging has improved with the advent of harmonic imaging, multiplane probes, contrast agents, and three-dimensional TEE. Future technology, including integrated backscatter (IBS), tissue Doppler, and strain imaging, will lead to further improvements in TEE. Thoracic aortic atherosclerosis and coronary atherosclerosis assessment should be performed in any patient undergoing TEE.

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“…[6][7][8][9][10][11] In this study, we aimed to assess the changes in coronary sinus flow at the onset and follow-up of myocarditis mimicking acute coronary syndrome using TTE.…”

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confidence: 99%

Coronary Sinus Flow Is Reduced and Recovered With Time in Viral Myocarditis Mimicking Acute Coronary Syndrome

Zheng

et al. 2016

J of Ultrasound Medicine

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A Transthoracic Doppler Echocardiographic Studyhe complete evaluation of acute myocarditis is very complex and includes the history, physical examination, blood work, echocardiography, coronary angiography, and endomyocardial biopsy. 1,2 The current histopathologic criteria for myocarditis (the Dallas criteria) require an inflammatory infiltrate and associated myocyte necrosis or damage that is not characteristic of an ischemic event. 3 However, the clinical presentation of myocarditis often mimics acute coronary syndrome. Whether abnormal myocardial perfusion is accompanied by myocarditis despite normal coronary angiographic findings remains unknown.The coronary sinus is the major venous collection system for the myocardial perfusion, 4,5 ORIGINAL RESEARCHObjectives-The clinical presentation of myocarditis often mimics acute coronary syndrome. Coronary sinus flow has been used for detection of the presence of myocardial ischemia. Whether myocarditis is associated with changes in coronary sinus flow remains unknown. The aim of this study was to assess coronary sinus flow at the onset and follow-up of myocarditis mimicking acute coronary syndrome using transthoracic Doppler echocardiography (TTE).Methods-Sixty-four patients with clinically diagnosed viral myocarditis mimicking acute coronary syndrome underwent TTE on days 3, 7, 30, 90, 180, and 360 after onset. Coronary sinus flow was compared among different points in time.Results-Compared to healthy participants, all patients with myocarditis had a larger cardiac size, reduced cardiac function, and electrocardiographic and myocardial enzyme abnormalities on days 3 and 7 days (P < .01; P < .05). They later had gradual restoration to normal levels. On days 3 and 7, the coronary sinus flow in patients with myocarditis was extremely lower than that in healthy participants (about one-tenth), although coronary angiography revealed unobstructed arteries. On days 30, 90, 180, and 360, the coronary sinus flow had been increasing; however, it was still far less than that in healthy participants (P < .01).Conclusions-Coronary sinus flow depicted by TTE is reduced but recovers with time in viral myocarditis mimicking acute coronary syndrome, which is a useful indicator in the follow-up of this type of myocarditis.

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Reduced coronary flow reserve in the coronary sinus is a predictor of hemodynamically significant stenoses of the left coronary artery territory

Cited by 16 publications

References 18 publications

Coronary sinus fow measured by pulsed Doppler ultrasound is a powerful indicator of coronary blood supply – a pig heart in vitro study.

Coronary sinus fow measured by pulsed Doppler ultrasound is a powerful indicator of coronary blood supply – a pig heart in vitro study.

Transesophageal Echocardiographic Evaluation of Atherosclerosis

Coronary Sinus Flow Is Reduced and Recovered With Time in Viral Myocarditis Mimicking Acute Coronary Syndrome

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