In the presence of severe stenosis, coronary
artery flow may be reduced at rest. Recent
advances in echocardiography have made noninvasive
sampling of velocities in the left an –
terior descending coronary artery (LAD) possible.
The aim of our study was to evaluate feasi –
bility and capability of transthoracic Doppler
to detect severe stenosis of the LAD. The study
population consisted of 42 subjects with suspected
coronary artery disease scheduled for
coronary angiography. All had complete transthoracic echocardiography and Doppler
sampling of LAD velocities. Quantitative cor –
onary angiography was performed within 24
hours of the echocardiogram. Correlations
between LAD velocity profile, measurements
and calculations, and the angiographic results
were performed. Six subjects had LAD occlusion,
10 had severe (>80% diameter) LAD
stenosis, and 26 had normal or non-occlusive
LAD disease. In all six subjects with LAD
occlusion, distal LAD velocities were not
detectable, while in the other 36 subjects, LAD
velocities were recorded indicating the vessels
were patent. In the 10 subjects with severe
LAD stenosis, the diastolic/systolic velocity
ratio was <1.5, while in those with nonsignifi cant LAD disease, the diastolic/systolic velocity ratio was >1.5 (P<0.005). Diastolic LAD flow was 21.8±13 mL/min in the presence of severe stenosis as compared to 48.5±20 mL/min in subjects without severe stenosis (P<0.0013). LAD velocities had high sensitiv - ity and specificity for the prediction of severe angiographic stenosis. Thus transthoracic Doppler measurement of LAD velocities is feas ible and can predict the presence of severe LAD stenosis or occlusion.
Angiography, coronary artery disease, coronary artery stenosis, transthoracic echocardiography.
Dawod Sharif, Department of Cardiology, Bnai Zion Medical Center, 47 Golomb St, Haifa, Israel. E-mail: dawod.sharif@b-zion.org.il
We acknowledge Professor
Majed Odeh (Head of Department of Internal
Medicine A, Bnai Zion Medical Center, Haifa,
Israel) for his help and advice.
2009-10-12T00:00:00

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