Abstract
Coronary artery imaging with transthoracic Doppler echocardiography is a simple and useful technique to diagnose significant coronary artery stenosis. The visualization of mosaic flow in the proximal left coronary artery provides a direct indication of the presence of significant stenosis at the corresponding site during routine echocardiography. Coronary flow velocity reserve (CFVR) has a high diagnostic accuracy and feasibility in detecting the presence of functionally significant coronary stenosis in the left anterior descending coronary artery (LAD) and in the right coronary artery. The measurement of CFVR in the LAD also provides prognostic information in patients with intermediate coronary stenosis. This review summarizes the utility of transthoracic coronary artery imaging.
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References
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Fusejima K. Noninvasive measurement of coronary artery blood flow using combined two-dimensional and doppler echocardiography. J Am Coll Cardiol. 1987;10:1024–31.
Caiati C, Montaldo C, Zedda N, Bina A, Iliceto S. New noninvasive method for coronary flow reserve assessment contrast-enhanced transthoracic second harmonic echo doppler. Circulation. 1999;99:771–8.
Hozumi T, Yoshida K, Ogata Y, Akasaka T, Asami Y, Takagi T, et al. Noninvasive assessment of significant left anterior descending coronary artery stenosis by coronary flow velocity reserve with transthoracic color doppler echocardiography. Circulation. 1998;97:1557–62.
Takeuchi M, Ogawa K, Wake R, Takise H, Miyazaki C, Otani S, et al. Measurement of coronary flow velocity reserve in the posterior descending coronary artery by contrast-enhanced transthoracic doppler echocardiography. J Am Soc Echocardiogr. 2004;17:21–7.
Hyodo E, Hirata K, Hirose M, Sakanoue Y, Nishida Y, Arai K, et al. Detection of restenosis after percutaneous coronary intervention in three major coronary arteries by transthoracic doppler echocardiography. J Am Soc Echocardiogr. 2010;23:553–9.
Takeuchi M. Transthoracic coronary artery imaging. In: Lang RM, Goldstein SA, Kronzon I, et al., editors: ASE’s comprehensive echocardiography. Philadelphia, PA: Elsevier; 2015. p. 426–8.
Hozumi T, Yoshida K, Akasaka T, Asami Y, Kanzaki Y, Ueda Y, et al. Value of acceleration flow and the prestenotic to stenotic coronary flow velocity ratio by transthoracic color doppler echocardiography in noninvasive diagnosis of restenosis after percutaneous transluminal coronary angioplasty. J Am Coll Cardiol. 2000;35:164–8.
Okayama H, Nishimura K, Saito M, Inoue K, Hiasa G, Sumimoto T, et al. Significance of the distal to proximal coronary flow velocity ratio by transthoracic doppler echocardiography for diagnosis of proximal left coronary artery stenosis. J Am Soc Echocardiogr. 2008;21:756–60.
Nohtomi Y, Takeuchi M, Nagasawa K, Arimura K, Miyata K, Kuwata K, et al. Simultaneous assessment of wall motion and coronary flow velocity in the left anterior descending coronary artery during dipyridamole stress echocardiography. J Am Soc Echocardiogr. 2003;16:457–63.
Meimoun P, Benali T, Sayah S, Luycx-Bore A, Boulanger J, Zemir H, et al. Evaluation of left anterior descending coronary artery stenosis of intermediate severity using transthoracic coronary flow reserve and dobutamine stress echocardiography. J Am Soc Echocardiogr. 2005;18:1233–40.
Rigo F, Gherardi S, Galderisi M, Pratali L, Cortigiani L, Sicari R, et al. The prognostic impact of coronary flow-reserve assessed by doppler echocardiography in non-ischaemic dilated cardiomyopathy. Eur Heart J. 2006;27:1319–23.
Tona F, Caforio ALP, Montisci R, Gambino A, Angelini A, Ruscazio M, et al. Coronary flow velocity pattern and coronary flow reserve by contrast-enhanced transthoracic echocardiography predict long-term outcome in heart transplantation. Circulation. 2006;114:I49–55.
Meimoun P, Benali T, Elmkies F, Sayah S, Luycx-Bore A, Doutrelan L, et al. Prognostic value of transthoracic coronary flow reserve in medically treated patients with proximal left anterior descending artery stenosis of intermediate severity. Eur J Echocardiogr. 2009;10:127–32.
Cortigiani L, Rigo F, Gherardi S, Bovenzi F, Molinaro S, Picano E, et al. Coronary flow reserve during dipyridamole stress echocardiography predicts mortality. J Am Coll Cardiol Img. 2012;5:1079–85.
Gaibazzi N, Rigo F, Lorenzoni V, Molinaro S, Bartolomucci F, Reverberi C, et al. Comparative prediction of cardiac events by wall motion, wall motion plus coronary flow reserve, or myocardial perfusion analysis: a multicenter study of contrast stress echocardiography. J Am Coll Cardiol Img. 2013;6:1–12. This multicenter study described the addition of CFVR or myocardial perfusion has a significant incremental prognostic power over conventional wall motion assessment during high-dose dipyridamole stress echocardiography.
Lowenstein JA, Caniggia C, Rousse G, Amor M, Sánchez ME, Alasia D, et al. Coronary flow velocity reserve during pharmacologic stress echocardiography with normal contractility adds important prognostic value in diabetic and nondiabetic patients. J Am Soc Echocardiogr. 2014;27:1113–9. This study showed CFVR has an independent predictor of mortality even in patients with negative pharmacologic stress echocardiography.
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Masaaki Takeuchi and Akemi Nakazono declare that they have no conflict of interest.
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This article contained one study with human subjects performed by any of the authors (Ref #4). All procedures performed in study were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Takeuchi, M., Nakazono, A. Coronary Artery Imaging with Transthoracic Doppler Echocardiography. Curr Cardiol Rep 18, 63 (2016). https://doi.org/10.1007/s11886-016-0740-y
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DOI: https://doi.org/10.1007/s11886-016-0740-y