Document Detail


Vasodilation of epicardial coronary artery can be measured with transthoracic echocardiography.
MedLine Citation:
PMID:  17188799     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Transthoracic Doppler echocardiography (TTE) has been introduced as a noninvasive tool to measure coronary flow velocity reserve (CFVR). Velocity measurement, however, fails to take into account epicardial coronary artery vasodilation during hyperemia and this may cause underestimation of CFVR measurements. Therefore, we sought to determine whether the vasodilation of epicardial coronary artery can be measured during cold pressor test (CPT) and adenosine infusion simultaneously with the flow velocity measurement using TTE. We studied 41 healthy nonsmoking men with a linear high-frequency 8.0-MHz transducer. The CPT and adenosine infusion dilated the diameter of the distal left anterior descending coronary artery (LAD) from 1.4 +/- 0.4 mm to 1.5 +/- 0.4 mm (14 +/- 13%, p < 0.01) and from 1.4 +/- 0.4 mm to 1.8 +/- 0.5 mm (31 +/- 19%, p < 0.01), respectively. The CPT increased flow velocity and calculated coronary blood flow rate (velocity time integral x cross-sectional area) from 0.23 +/- 0.05 m/s to 0.36 +/- 0.13 m/s (31 +/- 34%, p < 0.01) and from 8.1 +/- 4.2 mL/min to 11.4 +/- 6.0 mL/min (47 +/- 51%, p < 0.01). CFVR and calculated coronary blood flow rate reserve were 3.9 +/- 1.0 and 6.0 +/- 1.9, respectively. In Bland-Altman analysis, velocity measurements underestimated the vasodilation response of the CPT and adenosine compared with the measurements where epicardial diameter dilation was taken into account. Intra- and interobserver variability of diameter measurements was low (coefficient of variation [CV] 2.6 to 6.5%). Day-to-day, within-day and intersonographer variabilities were of similar magnitude (CV 4.6 to 8.2%), suggesting good reproducibility. This study demonstrates that TTE can be used to assess changes in both epicardial coronary artery diameter and flow velocity simultaneously in the distal LAD artery.
Authors:
Tuomas O Kiviniemi; Jyri O Toikka; Juha W Koskenvuo; Antti Saraste; Markku Saraste; Jussi P Pärkkä; Olli T Raitakari; Jaakko J Hartiala
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Ultrasound in medicine & biology     Volume:  33     ISSN:  0301-5629     ISO Abbreviation:  Ultrasound Med Biol     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-26     Completed Date:  2007-07-17     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0410553     Medline TA:  Ultrasound Med Biol     Country:  England    
Other Details:
Languages:  eng     Pagination:  362-70     Citation Subset:  IM    
Affiliation:
Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland. tuoski@utu.fi
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MeSH Terms
Descriptor/Qualifier:
Adenosine / administration & dosage
Adult
Blood Flow Velocity / physiology
Cold Temperature
Coronary Circulation / physiology
Coronary Vessels / drug effects,  ultrasonography*
Echocardiography, Doppler / methods*
Humans
Immersion
Infusions, Intravenous
Male
Pericardium / ultrasonography
Reproducibility of Results
Vasodilation / drug effects,  physiology*
Vasodilator Agents / administration & dosage
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 58-61-7/Adenosine

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


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