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Noninvasive Assessment of Significant Right Coronary Artery Stenosis Based on Coronary Flow Velocity Reserve in the Right Coronary Artery by Transthoracic Doppler Echocardiography
Author(s) -
Ueno Yoshiki,
Nakamura Yasuyuki,
Kinoshita Masahiko,
Fujita Tamotsu,
Sakamoto Taizou,
Okamura Hiroshi
Publication year - 2003
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1046/j.1540-8175.2003.03085.x
Subject(s) - cardiology , medicine , right coronary artery , doppler echocardiography , coronary flow reserve , doppler effect , stenosis , artery , blood flow , coronary angiography , myocardial infarction , diastole , physics , blood pressure , astronomy
Background: Coronary flow velocity reserve (CFVR) measured by transthoracic Doppler echocardiography (TTDE) has been reported to be useful for the noninvasive assessment of coronary stenosis in the left anterior descending artery. However, the measurement of CFVR in the right coronary artery by TTDE has not yet been validated in a clinical study. Objective: The aim of this study was to evaluate whether CFVR by TTDE can detect significant stenosis in the right coronary artery. Methods: We studied 50 patients who underwent coronary angiography. Coronary flow velocity in the posterior descending branch of the right coronary artery (PD) was measured by TTDE both at baseline and during hyperemia induced by the intravenous infusion of adenosine triphosphate. CFVR was calculated as the hyperemia/baseline (average diastolic peak velocity). Results: Adequate spectral Doppler recordings in the PD were obtained in 36 patients including 26 patients who were given an echocardiographic contrast agent to improve Doppler spectral signals. The study population was divided into 2 groups with (Group A;n = 11) and without (Group B;n = 25) significant stenosis in the right coronary artery. CFVR in Group A was significantly smaller than that in Group B (1.6 ± 0.3versus2.5 ± 0.4;P < 0.0001). The sensitivity of a CFVR of <2.0 for predicting the presence of significant stenosis in the right coronary artery was 91%, and the specificity was 88%. Conclusions: The measurement of CFVR in the PD by TTDE is useful for the noninvasive assessment of significant stenosis in the right coronary artery. (ECHOCARDIOGRAPHY, Volume 20, August 2003)