Document Detail

Estimation of coronary flow velocity reserve using transthoracic Doppler echocardiography and cold pressor test might be useful for detecting of patients with variant angina.
MedLine Citation:
PMID:  20113325     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The cold pressor test (CPT) has been used to detect variant angina, but its sensitivity in predicting vasospasm is low. The aim of this study was to determine whether estimates of the coronary flow velocity reserve (CFVR) in the distal left anterior descending coronary artery (dLAD) using transthoracic echocardiography (TTE) and CPT are useful tool to predict variant angina. METHODS: 65 patients (mean age = 52 +/- 10 years; male:female = 41:24) who had normal coronary artery on angiography and underwent acetylcholine provocation test were enrolled and divided into the spasm group (n = 31) and the no spasm group (n = 34). During CPT, the peak (PDV) and mean diastolic flow velocity (MDV) of the dLAD were estimated using TTE with a high-frequency transducer, and electrocardiography, blood pressures, heart rate, and symptoms were monitored every 30 seconds. CPT%PDV and CPT%MDV were defined as the percentage changes in PDV and MDV during CPT, respectively. RESULTS: CPT%PDV was 4.99 +/- 23.62% in the spasm group and 52.75 +/- 24.78% in the no spasm group (P < 0.001). CPT%MDV was 6.83 +/- 23.81% in the spasm group and 50.22 +/- 27.83% in the no spasm group (P < 0.001). CPT%PDV<31.1% had a sensitivity of 93.5% and a specificity of 82.4% in predicting variant angina (95% confidence interval [CI]: 0.939-0.979, P < 0.001). CPT%MDV<30.55% had a sensitivity of 90% and a specificity of 76.5% in predicting variant angina (95% CI: 0.884-0.950, P < 0.001). CONCLUSION: The measurement of changes in the coronary flow velocity of the dLAD using TTE and CPT might be useful for the estimation of endothelial dysfunction in patients with variant angina.
Hui-Jeong Hwang; Woo-Baek Chung; Jeong-Hwan Park; Su-Sung Oh; Jong-Won Chung; Yun-Seok Choi; Ho-Joong Youn
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Publication Detail:
Type:  Journal Article     Date:  2010-01-22
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  27     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-06-09     Completed Date:  2010-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  435-41     Citation Subset:  IM    
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 150-713, Korea.
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MeSH Terms
Angina Pectoris, Variant / ultrasonography*
Blood Flow Velocity
Coronary Angiography / methods
Coronary Vessels / ultrasonography*
Echocardiography, Doppler / methods*
Echocardiography, Stress / methods*
Middle Aged
Observer Variation
Predictive Value of Tests
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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