Transthoracic echocardiographic visualization of coronary artery blood flow and assessment of coronary flow reserve in the right coronary artery: A first report of 3 patients

Tries, Hans-Peter; Lambertz, Heinz; Lethen, Harald

doi:10.1067/mje.2002.118525

Cited by 21 publications

(6 citation statements)

References 16 publications

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“…The method provides reliable measurements of CFR in the distal or middle segment of left anterior descending coronary artery (LAD), using pulsed wave Doppler echocardiography under the guidance of color Doppler flow mapping. The development of the transthoracic imaging technique (exploring various transducer beam orientations) extended the possibilities of imaging blood flow in the circumflex coronary artery [1] and right coronary artery (RCA) [24-26]. As regards the transthoracic Doppler assessment of CFR in the RCA we are able to measure the coronary flow velocity in proximal RCA and in its distal branch i.e.…”

Section: Introductionmentioning

confidence: 99%

Transthoracic Doppler echocardiography – noninvasive diagnostic window for coronary flow reserve assessment

Dimitrow

2003

Cardiovasc Ultrasound

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This review focuses on transthoracic Doppler echocardiography as noninvasive method used to assess coronary flow reserve (CFR) in a wide spectrum of clinical settings. Transthoracic Doppler echocardiography is rapidly gaining appreciation as popular tool to measure CFR both in stenosed and normal epicardial coronary arteries (predominantly in left anterior descending coronary artery). Post-stenotic CFR measurement is helpful in: functional assessment of moderate stenosis, detection of significant or critical stenosis, monitoring of restenosis after revascularization. In the absence of stenosis in the epicardial coronary artery, decreased CFR enable to detect impaired microvascular vasodilatation in: reperfused myocardial infarct, arterial hypertension with or without left ventricular hypertrophy, diabetes mellitus, hypercholesterolemia, syndrome X, hypertrophic cardiomyopathy. In these diseases, noninvasive transthoracic Doppler echocardiography allows for serial CFR evaluations to explore the effect of various pharmacological therapies.

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Section: Introductionmentioning

confidence: 99%

Transthoracic Doppler echocardiography – noninvasive diagnostic window for coronary flow reserve assessment

Dimitrow

2003

Cardiovasc Ultrasound

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“…In contrast to the direct morphological visualisation by 2D echocardiography, the visualisation of the coronary artery flow by transthoracic colour-coded Doppler echocardiography is established in clinical practice for the detection of coronary artery disease by determining the coronary flow reserve (CFR) during adenosine or dipyridamole stress ( 4 , 5 , 11 , 15 , 16 , 17 , 18 ). However, the visualisation of coronary artery flow by colour-coded Doppler echocardiography is primarily used to detect and target the vessel branches for subsequent quantification of coronary artery flow by pulsed-wave Doppler echocardiography.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of 3D4D echocardiography for the detection of colour-coded flow in the left anterior descending artery

Stoebe¹,

Pfeiffer²,

Hagendorff³

2014

Echo Research and Practice

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The aim of this study was to test the feasibility of the visualisation of 3D4D coronary flow in detectable segments of coronary arteries. Regarding the feasibility of this new approach, the hypothesis was proposed that the flow signals of the course of detectable coronary arteries can be better visualised by 3D4D echocardiography than by the conventional 2D approach. A total of 30 consecutive patients with sinus rhythm, in whom the distal left anterior descending artery (LAD) was visualised by 2D colour-coded Doppler echocardiography, were selected for 3D4D scanning procedures. All measurements were performed using a Vivid 7 or E9. All segments visualised by 2D colour-coded Doppler echocardiography were also examined by 3D4D echocardiography. Using defined settings, the width of the colour-coded flow signal differs significantly between 2D- and 3D4D echocardiography. The length of larger segments of the visualised colour-coded flow signal of the coronary flow could be better detected with 2D imaging. Small segments of coronary artery flow (<11 mm), however, could be significantly better visualised by 3D4D echocardiography. The main advantage of 3D4D echocardiography of the coronary artery flow is the visualisation of the proportions of vessels with complex morphology. 3D4D echocardiography of LAD flow by colour-coded Doppler echocardiography raises new possibilities for the direct flow visualisation of the detectable segments of coronaries. With its sufficiently high spatial and temporal resolution, this new method has the potential to be implemented in clinical scenarios. The possible application to the quantification of stenoses by the flow visualisation has to be evaluated in further studies.

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“…Hierzu wird die koronare Flussgeschwindigkeit vor und nach medikamentös induzierter koronarer Vasodilatation bestimmt. Echokardiographisch gelingt dies mit hoher Erfolgsrate im Ramus interventricularis anterior (RIVA) und in der Arteria mammaria interna nach Bypass-Operation; auch für die rechte Koronararterie (RCA) liegen derzeit valide Daten vor [16,20].…”

Section: Introductionunclassified

“…Die Anlotung des distalen RIVA-Segmentes hat im Vergleich zum mittleren Segment den Vorteil der unmittelbaren Nähe zum Koronargefäû bei günstigerem Dopplerwinkel und geringerer Beeinträchtigung durch Atemartefakte. Allerdings ist das Gefäû in diesem Bereich dünnkalibriger.Anlottechnik der RCA Der Ramus interventricularis posterior (RIVP) der rechten Koronararterie kann im Sulcus interventricularis posterior dargestellt und die koronare Flussgeschwindigkeit gemessen werden, indem ausgehend von einem apikalen 2-Kammer-Blick der Schallkopf im Gegenuhrzeigersinn gedreht und leicht anterior flektiert wird[20]. Die Darstellung des RIVP sowie die Erfassung der CFR sind in Abb.…”

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Erfassung der koronaren Flussreserve mit hochauflösender Echokardiographie - Klinischer Stellenwert in der kardiologischen Diagnostik

Lambertz¹,

Lethen²,

Tries³

et al. 2004

Ultraschall in Med

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Coronary flow reserve can be determined echocardiographically in the LAD in about 90 % and in the RCA in more than 80 % of patients respectively by the use of modern high-resolution ultrasound equipment. For this purpose either high frequency fundamental imaging or echo-contrast enhanced harmonic Doppler technology is used. The main advantage of the method lies in its noninvasiveness and the lack of radiation exposure. In combination with coronary morphologic findings obtained from heart catheterization, CFR is helpful in the planning of further invasive procedures for coronary artery disease and in the estimation of the prognosis of such procedures. The functional status after PTCA of LAD/RCA or mammary bypass surgery can be evaluated during follow-up monitoring. Alteration in the coronary microcirculation can also be discovered in a non-invasive way, improvement of microcirculatory disorders by adequate therapy can be assessed by serial measurements of CFR.

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Transthoracic echocardiographic visualization of coronary artery blood flow and assessment of coronary flow reserve in the right coronary artery: A first report of 3 patients

Cited by 21 publications

References 16 publications

Transthoracic Doppler echocardiography – noninvasive diagnostic window for coronary flow reserve assessment

Transthoracic Doppler echocardiography – noninvasive diagnostic window for coronary flow reserve assessment

Feasibility of 3D4D echocardiography for the detection of colour-coded flow in the left anterior descending artery

Erfassung der koronaren Flussreserve mit hochauflösender Echokardiographie - Klinischer Stellenwert in der kardiologischen Diagnostik

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