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

doi:10.1186/1476-7120-5-22

Cardiovascular Ultrasound

Volume 5

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Auriti A
Pristipino C
Cianfrocca C
Granatelli A
Guido V
Pelliccia F
Greco S
Richichi G
Santini M

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Auriti A
Pristipino C
Cianfrocca C
Granatelli A
Guido V
Pelliccia F
Greco S
Richichi G
Santini M
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Research

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

Antonio Auriti¹ , Christian Pristipino² , Cinzia Cianfrocca¹ , Antonino Granatelli² , Vincenzo Guido¹ , Francesco Pelliccia² , Salvatore Greco¹ , Giuseppe Richichi² and Massimo Santini¹

¹Department of Cardiovascular Disease – Echocardiography Unit – S. Filippo Neri Hospital, Rome, Italy

²Coronary Intervention Unit and ROMA ("Ricerche Orientate sulla Malattia Aterosclerotica") core lab S. Filippo Neri Hospital, Rome, Italy

author email corresponding author email

Cardiovascular Ultrasound 2007, 5:22doi:10.1186/1476-7120-5-22


Published:	16 June 2007

Abstract

Background

Coronary 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).

Aim

To evaluate the reliability of TTDE in assessing CFR in LCx when compared to the intracoronary Doppler flow-wire gold standard.

Methods

we 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.

Results

CFR 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%).

Conclusion

CFR of LCx artery can be obtained noninvasively with TTDE.