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Hypertension is the leading modifiable risk factor for global cardiovascular disease, responsible for an estimated 10.8 million deaths and more than 200 million disability-adjusted life years annually.1 Despite the availability of effective pharmacological and lifestyle interventions, prevalence continues to rise, particularly in low- and middle-income countries (LMICs), where over three-quarters of all cases now occur.2 The condition’s […]

Differences in coronary artery blood velocities in the setting of normal coronary angiography and normal stress echocardiography

Dawod Sharif, Amal Sharif-Rasslan, Camilia Shahla, Amin Khalil, Uri Rosenschein
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Published Online: Aug 17th 2018 Heart International 2015;10(1):e6-e11 DOI: https://doi.org/10.5301/heartint.5000221
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Abstract

Overview

Background. Normal left anterior descending (LAD) coronary artery as determined by coronary angiography is
considered not only to reflect normal angiography but also to correlate with normal anatomy and function. However,
subjects who undergo coronary angiography may differ from those who do not need to have invasive evaluation
even if their functional noninvasive studies like dobutamine stress echocardiography (DSE) were normal.
Aim. LAD velocities in subjects with normal angiography and those with normal DSE are equal.
Methods. A total of 244 subjects were evaluated, 78 had normal LAD by angiography and 166 had normal LAD by
DSE. All had Doppler sampling of LAD velocities by transthoracic echocardiography.
Results. Velocity was higher in the angiographic subgroup in diastole 41 ± 23 vs 33 ± 14 cm/s, p = 0.0078; systole
18 ± 14 vs 13 ± 7 cm/s, p = 0.012; diastolic integral 12.6 ± 5 vs 9.8 ± 3.8 cm, p = 3.15 × 10-5; systolic velocity integral
4 ± 2.9 vs 2.8 ± 1.9, p = 0.0014. While heart rate was similar in both groups, the product of diastolic velocity
integral and heart rate of the LAD in the angiographic group was higher: 902 ± 450 vs 656 ± 394, p = 0.00599.
Diastolic velocity deceleration time was similar in both groups. Coronary flow reserve defined as diastolic velocity
ratio before and immediately after DSE correlated negatively with baseline velocity, r = -0.4.
Conclusions. Mode of defining normality of coronary artery affects velocity behavior of the vessel, reflecting
functional differences possibly related to microvasculature and vasodilatation.

Keywords

Coronary angiography, Dobutamine stress echocardiography, Doppler, Left anterior descending coronary artery

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Article Information

Disclosure

Financial support: No grants or funding have been received for this
study.

Correspondence

Dawod Sharif, MD Department of Cardiology Bnai Zion Medical Center 47 Golomb St, Haifa, Israel dawod.sharif@b-zion.org.il

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