Study of Coronary Sinus Flow Reserve Through Transesophageal Doppler Echocardiography in Normal Subjects

Filho, José Ramos; Ramires, José Antônio Franchini; Turina, M; Medeiros, Carlos Roberto de; Lachat, Mário; Tsutsui, Jeane Mike

doi:10.1590/s0066-782x2002001100001

Cited by 7 publications

(6 citation statements)

References 24 publications

(34 reference statements)

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“…Over the last decade, coronary flow reserve (CFR) in the CS has been used to diagnose significant coronary artery stenosis by transesophageal Doppler echocardiography (TEE) due to an inadequate visualization of the coronary arteries, especially their mid- and distal parts (5–7). TEE is a semi-invasive procedure and vasodilator drugs, such as adenosine, are not always harmless.…”

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confidence: 99%

Sex-specific assessment of reduced coronary sinus flow in non-hypertensive patients with coronary artery disease at rest

Zheng

Yang

2013

Libyan Journal of Medicine

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BackgroundAccess to data on the coronary flow in the coronary sinus (CS) can aid in the diagnosis of coronary artery disease (CAD). We tested the hypothesis that assessing the CS flow by transthoracic Doppler echocardiography (TTE) at rest can detect coronary artery stenosis in non-hypertensive patients.MethodsThe antegrade phase of coronary flow in the CS was analyzed and compared in 140 male and 135 female non-hypertensive subjects who had all undergone coronary angiography.ResultsThere were statistically significant differences noted between males and females for the CS flow both in normal subjects and patients with CAD. Compared with normal subjects, patients with CAD had significantly lower blood flow in the CS both in males (196.6±174.31 vs. 367.65±168.04 ml/min, P<0.01) and females (183.04±65.46 vs. 244.13±135.43 ml/min P<0.01). For males, the diagnostic sensitivity, specificity, and accuracy of the cutoff value of the CS flow (206 ml/min) for predicting a significant coronary artery stenosis (>70%) were 91.67%, 81.25%, and 85.71%, respectively. For females, those of the cutoff value of the CS flow (195 ml/min) were 85.71%, 75%, and 80%, respectively.ConclusionTTE can effectively detect coronary hemodynamically significant stenosis in non-hypertensive male and female patients at different cutoff values.

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confidence: 99%

Sex-specific assessment of reduced coronary sinus flow in non-hypertensive patients with coronary artery disease at rest

Zheng

Yang

2013

Libyan Journal of Medicine

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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: 99%

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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“…The average value of three spectral and planimetric envelopes was used. Global left ventricular perfusion (mL/minute g) = the flow per minute/LVM (M-mode) (3). …”

Section: Methodsmentioning

confidence: 99%

“…The assessment of the coronary artery stenosis by conventional echocardiography remains challenging due to inadequate visualization of the coronary arteries, especially for the mid and distal parts (1-3). As 95% of the left ventricular perfusion drains to the right atrium through the coronary sinus (4), the flow in this vessel is a good representation of the global left ventricular perfusion.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Efficacy of Conventional Echocardiographic Parameters in the Diagnosis of Significant Coronary Artery Stenosis

Xiao

Yang

2014

Iran J Radiol

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Background:For diagnosis of significant coronary artery stenosis, the most accurate parameter among the conventional echocardiographic parameters remains unknown.Objectives:To assess the diagnostic efficacy of conventional echocardiographic parameters in the diagnosis of significant coronary artery stenosis and their correlation with the percentage of stenosis considering conventional coronary angiography as gold standard.Patients and Methods:Seventy eight individuals were included in the study. The three echocardiographic parameters including the coronary sinus flow [flow (mL/minute)], the global left ventricular perfusion by dividing the coronary sinus flow by left ventricular mass [flow/LVM (mL/minute)] and the difference between the left ventricular mass at end diastole and peak systole using area-length calculation methods [LV (d-s) mass A-L] were assessed using receiver operating characteristic (ROC) analysis for their accuracy to distinguish between normal subjects and patients with significant (> 50%) coronary artery disease (CAD).Results:Flow (mL/minute), flow/LVM (mL/minuteg) and LV (d-s) mass A-L all correlated significantly with the percentage of stenosis (r = -0.64, P < 0.001; r = -0.47, P < 0.001; r = -0.56, P < 0.001, respectively). With the use of the percentage of stenosis > 50% as the criteria to distinguish patients with or without CAD, the areas under the ROC curve for flow (mL/minute) were 0.75, while they were 0.57 for flow/LVM (mL/minuteg) and 0.59 for LV (d-s) mass A-L. The percentage of stenosis > 70% was best detected by coronary sinus flow < 198 mL/minute (sensitivity, 81.35%; specificity, 70.37%; positive predictive value, 63.63%; negative predictive value, 86.36% and accuracy, 75%; P < 0.001).Conclusions:The coronary sinus flow per minute is the most accurate parameter among the three echocardiographic parameters mentioned above for the assessment of significant stenosis of the coronary artery.

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Study of Coronary Sinus Flow Reserve Through Transesophageal Doppler Echocardiography in Normal Subjects

Cited by 7 publications

References 24 publications

Sex-specific assessment of reduced coronary sinus flow in non-hypertensive patients with coronary artery disease at rest

Sex-specific assessment of reduced coronary sinus flow in non-hypertensive patients with coronary artery disease at rest

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

Comparison of the Efficacy of Conventional Echocardiographic Parameters in the Diagnosis of Significant Coronary Artery Stenosis

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