A novel method for left anterior coronary artery flow velocity assessment by transthoracic echocardiography at the peak of a supine bicycle test
Language English Country Great Britain, England Media print-electronic
Document type Journal Article
PubMed
26676763
DOI
10.1177/0284185115617350
PII: 0284185115617350
Knihovny.cz E-resources
- Keywords
- Coronary flow reserve, LAD flow, coronary flow velocity, exercise echo, visualization of coronary artery,
- MeSH
- Bicycling physiology MeSH
- Coronary Angiography MeSH
- Coronary Circulation * MeSH
- Coronary Disease diagnostic imaging physiopathology MeSH
- Middle Aged MeSH
- Humans MeSH
- Echocardiography, Doppler, Pulsed * MeSH
- Blood Flow Velocity * MeSH
- Case-Control Studies MeSH
- Echocardiography, Stress * MeSH
- Exercise Test * MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: Assessment of coronary flow is only performed during pharmacological tests. Supine bicycle tests permit the visualization of coronary flow assessments during exercise. PURPOSE: To assess the parameters of coronary flow in the left anterior descending artery (LAD) during exercise, which could be a sign of significant LAD narrowing. MATERIAL AND METHODS: A total of 253 patients were enrolled: Group 1, 186 non-selective participants before undergoing a coronary angiography; and Group 2, 67 controls without coronary artery disease (CAD). All the patients performed a supine bicycle echocardiography test. Coronary flow velocities and coronary flow velocity reserve (CFVR) were measured at the mid-segment of the LAD during exercise. Patients in Group 1 underwent a coronary angiography. RESULTS: In comparison with participants without significant LAD stenosis, patients with LAD lesions had a lower ΔV (16 ± 21 vs. 27 ± 20 cm/s, P < 0.04) and a lower CFVR (1.5 ± 0.8 vs. 2.0 ± 0.6, P < 0.004). In comparison with patients without significant proximal LAD stenosis, the patients with proximal LAD lesions had a lower flow velocity at the peak of exercise (49 ± 32 vs. 61 ± 19 cm/s, P < 0.02), a lower ΔV (13 ± 19 vs. 26 ± 22 cm/s, P < 0.004), and a lower CFVR (1.4 ± 0.6 vs. 1.9 ± 0.7, P < 0.0001). In comparison with the control group, the patients with LAD stenosis had a lower flow velocity at the peak of exercise, a lower ΔV, and a lower CFVR. CONCLUSION: Non-invasive CFVR measurement in the LAD could provide valuable additional information to a conventional echocardiography exercise test. In routine clinical practice, CFVR is sufficient for a diagnosis of severe stenosis.
5th Department of Internal Medicine University Hospital Bratislava Slovak Republic
Egom Clinical and Translational Research Services Halifax NS Canada
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