Document Detail

Assessment of intermediate stenosis in the left anterior descending coronary artery with contrast-enhanced transthoracic Doppler echocardiography.
MedLine Citation:
PMID:  12702929     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Visual or quantitative assessment of coronary angiography may not exactly predict the physiological significance of intermediate (40-70%) coronary stenosis. Coronary flow reserve is a well-established marker of the functional significance of coronary stenosis. OBJECTIVES: The aim of this study was to compare the coronary flow velocity reserve (CFVR) using contrast-enhanced transthoracic Doppler echocardiography (CE-TTDE) with thallium-201 imaging in assessment of intermediate lesions in the left anterior descending coronary artery (LAD). METHODS: A consecutive series of 50 patients with intermediate stenosis in the LAD underwent pharmacological stress thallium-201 imaging and CFVR measured by CE-TTDE. RESULTS: CFVR could be measured in 49 of 50 patients by the present method. A CFVR <2.0 predicted the presence of a stress thallium defect in 12 of 14 patients (agreement=90%, kappa=0.76, P < 0.001). The sensitivity and specificity of CFVR for stress thallium-201 results were 86 and 91%, respectively. In contrast, significant stenosis (>50% by diameter) showed fair agreement for stress thallium defects (agreement=59%, kappa=0.28, P < 0.05). CONCLUSIONS: In the evaluation of intermediate lesions in the LAD, CFVR as assessed by CE-TTDE could accurately predict the presence of ischemia on stress thallium imaging, whereas angiographic stenosis did not yield reliable results.
Hideki Okayama; Takumi Sumimoto; Go Hiasa; Kazuhisa Nishimura; Norikatsu Morioka; Kouzo Yamamoto; Hiroyuki Kawada
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Coronary artery disease     Volume:  14     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-04-18     Completed Date:  2003-09-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  247-54     Citation Subset:  IM    
Department of Carediology, Kitaishikai Hospital, 2632-3 Tokunomori, Ozu, Ehime 795-0061, Japan.
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MeSH Terms
Adenosine Triphosphate / diagnostic use
Arteries / physiopathology,  radionuclide imaging,  ultrasonography
Blood Flow Velocity / physiology
Coronary Angiography
Coronary Circulation / physiology
Coronary Stenosis / diagnosis*,  epidemiology,  physiopathology
Coronary Vessels / physiopathology,  radionuclide imaging,  ultrasonography
Echocardiography, Doppler / methods
Follow-Up Studies
Image Enhancement*
Infusions, Intravenous
Middle Aged
Observer Variation
Sensitivity and Specificity
Severity of Illness Index
Thallium Radioisotopes / diagnostic use
Tomography, Emission-Computed, Single-Photon
Reg. No./Substance:
0/Thallium Radioisotopes; 56-65-5/Adenosine Triphosphate

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