Detection of severe left anterior descending coronary artery stenosis by transthoracic evaluation of resting coronary flow velocity dynamics
Abstract
Overview
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.
Keywords
Angiography, coronary artery disease, coronary artery stenosis, transthoracic echocardiography.
Article Information
Correspondence
Dawod Sharif, Department of Cardiology, Bnai Zion Medical Center, 47 Golomb St, Haifa, Israel. E-mail: dawod.sharif@b-zion.org.il
Acknowledgements
We acknowledge Professor
Majed Odeh (Head of Department of Internal
Medicine A, Bnai Zion Medical Center, Haifa,
Israel) for his help and advice.
Received
2009-10-12T00:00:00
Further Resources
Trending Topic
As of the publication of this article, the coronavirus disease 2019 (COVID-19) infection has affected over 400 million people around the world and caused over 6 million deaths.1Â Although COVID-19 infection predominantly affects the respiratory system, studies have described a wide spectrum of cardiovascular manifestations, including asymptomatic myocardial injury, myocardial infarction and myocarditis.2Â Echocardiography is an easily […]
More than half of acute coronary syndromes (ACS) occur in subjects with no significant coronary stenosis.1Â In view of the number of patients dying each year from a heart attack, the question of identifying these patients is of primary importance. ...
Left main Stenosis Stenting Normalizes Wall Shear Stress of Ascending Aorta in Bicuspid Aortic Valve
Bicuspid aortic valve (BAV) represents the most common congenital cardiac anomaly, with a prevalence ranging between 1% and 2% in the general population.1Â BAV is known to be associated with dilation and dissection of the ascending aorta, and the significantly higher shear ...
Anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS) is one of the most clinically relevant abnormalities among the wide spectrum of coronary artery anomalies.1Â Sudden cardiac death has been related to myocardial bridges, ectopic origin of the ...
Introduction:Â The restriction of activation mapping to the ventricular surface of contemporary mapping systems often leads to failure to correctly identify the true site of origin (SOO) of intramural and/or sub-epicardial Vas and lower procedural success. Electromechanical wave imaging (...
Introduction: Leadless left ventricular (LV) endocardial pacing with the WiSE-CRT System (EBR Systems Inc) is a novel treatment in the field of cardiac resynchronization therapy (CRT). The system was designed to provide lateral wall LV pacing (LVP) in response to ...
Background:Â The spatial resolution of a mapping catheter is determined by factors such as the quantity of electrodes, their inter-electrode spacing, and the various configurations in which they are utilized. These factors impact the interpretation of wavefront dynamics during cardiac ...
Background:Â Obesity-related cardiac remodelling may be reflected through electrocardiogram (ECG) changes. Based on this premise, we hypothesised that an artificial intelligence (AI)-ECG model could be trained to predict body mass index (BMI), and that the difference between AI-ECG predicted ...
Athletes represent the fittest individuals in our society, yet paradoxically carry an increased risk of sudden cardiac death (SCD) when compared to sedentary individuals with the same cardiac disease.1,2 Two recent studies have provided a realistic prevalence of young SCD ...
Sudden cardiac death arises from the unexpected stopping of the heart and is associated with up to a half of cardiovascular deaths. We discuss with Professor Martin Borggrefe how to identify patient populations at risk of sudden cardiac death (...
Brugada syndrome (BrS) is a genetic arrhythmia syndrome with increased risk of sudden cardiac death. Unmasking a type I BrS electrocardiogram (ECG) pattern after administration of sodium channel blockers may be associated with an increase in epicardial substrate abnormalities. We ...
...
...
Log into your Touch Account
Earn and track your CME credits on the go, save articles for later, and follow the latest congress coverage.
Sign up with an Email
Or use a .
This Functionality is for
Members Only
Explore the latest in medical education and stay current in your field. Create a free account to track your learning.
