BACKGROUND: The coronary flow velocity (CFV) has been used to estimate coronary flow reserve (CFR) during dobutamine stress echocardiography (DSE). However, the relationship of the CFR to myocardial wall thickening (WT) has not been investigated. OBJECTIVES: The aims of this study were: (1) to assess the feasibility of obtaining systolic and diastolic CFV and thus CFR during DSE and (2) to assess the relation between CFR and stress induced WT. METHODS: Distal left anterior descending CFV was recorded by transthoracic Doppler echocardiography during DSE. Systolic and diastolic velocities were measured at rest, low and peak dobutamine doses, simultaneously, WT of distal anteroseptal segment was assessed by 2D-guided M-mode. The CFV and CFR of patients with normal WT defined as thickening of >50% (group 1) at peak stress were compared to that of patients with abnormal WT (group 2). RESULTS: A total of 67 patients, 34 females and 33 males (mean age of 66.5+/-14.5 years) were studied. The feasibility of assessing the CFR was 97% from peak diastolic velocity, 91% from diastolic time velocity integral, 91% from peak systolic velocity, and 90% from systolic time velocity integral. Contrast agent was used in 6 patients (7%) to obtain the CFV. Twenty-five of 67 patients demonstrated abnormal wall thickening. The percentage of WT was 30.9+/-15.7% in group 2 compared to 80.8+/-24.3% in group 1 (p<0.0001). The 25 patients in group 2, who developed abnormal WT, demonstrated significantly lower CFR at low dose, as well as at peak dobutamine dose compared to patients in group 1 (1.55+/-0.5 vs. 2.03+/-0.6, p<0.008). CONCLUSION: CFV and CFR assessments are feasible during DSE with second harmonic imaging in most patients without use of contrast agent. CFR assessment during DSE correlates well with wall thickening and was able to detect ischemia early before development of wall motion abnormality.
BACKGROUND: The coronary flow velocity (CFV) has been used to estimate coronary flow reserve (CFR) during dobutamine stress echocardiography (DSE). However, the relationship of the CFR to myocardial wall thickening (WT) has not been investigated. OBJECTIVES: The aims of this study were: (1) to assess the feasibility of obtaining systolic and diastolic CFV and thus CFR during DSE and (2) to assess the relation between CFR and stress induced WT. METHODS: Distal left anterior descending CFV was recorded by transthoracic Doppler echocardiography during DSE. Systolic and diastolic velocities were measured at rest, low and peak dobutamine doses, simultaneously, WT of distal anteroseptal segment was assessed by 2D-guided M-mode. The CFV and CFR of patients with normal WT defined as thickening of >50% (group 1) at peak stress were compared to that of patients with abnormal WT (group 2). RESULTS: A total of 67 patients, 34 females and 33 males (mean age of 66.5+/-14.5 years) were studied. The feasibility of assessing the CFR was 97% from peak diastolic velocity, 91% from diastolic time velocity integral, 91% from peak systolic velocity, and 90% from systolic time velocity integral. Contrast agent was used in 6 patients (7%) to obtain the CFV. Twenty-five of 67 patients demonstrated abnormal wall thickening. The percentage of WT was 30.9+/-15.7% in group 2 compared to 80.8+/-24.3% in group 1 (p<0.0001). The 25 patients in group 2, who developed abnormal WT, demonstrated significantly lower CFR at low dose, as well as at peak dobutamine dose compared to patients in group 1 (1.55+/-0.5 vs. 2.03+/-0.6, p<0.008). CONCLUSION: CFV and CFR assessments are feasible during DSE with second harmonic imaging in most patients without use of contrast agent. CFR assessment during DSE correlates well with wall thickening and was able to detect ischemia early before development of wall motion abnormality.
Authors: José Sebastião de Abreu; José Wellington Oliveira Lima; Tereza Cristina Pinheiro Diógenes; Jordana Magalhães Siqueira; Nayara Lima Pimentel; Pedro Sabino Gomes Neto; Marília Esther Benevides de Abreu; José Nogueira Paes Júnior Journal: Arq Bras Cardiol Date: 2013-12-21 Impact factor: 2.000
Authors: José Sebastião de Abreu; Eduardo Arrais Rocha; Isadora Sucupira Machado; Isabelle O Parahyba; Thais Brito Rocha; Fernando José Villar Nogueira Paes; Tereza Cristina Pinheiro Diogenes; Marília Esther Benevides de Abreu; Ana Gardenia Liberato Ponte Farias; Marcia Maria Carneiro; José Nogueira Paes Journal: Arq Bras Cardiol Date: 2017-04-20 Impact factor: 2.000
Authors: Massimo Nardone; Mary McCarthy; Chris I Ardern; Heather Edgell; Olga Toleva; Lynne E Nield; Steven E S Miner Journal: CJC Open Date: 2020-09-25
Authors: Srdjan B Aleksandric; Ana D Djordjevic-Dikic; Vojislav L Giga; Milorad B Tesic; Ivan A Soldatovic; Marko D Banovic; Milan R Dobric; Vladan Vukcevic; Miloje V Tomasevic; Dejan N Orlic; Nikola Boskovic; Ivana Jovanovic; Milan A Nedeljkovic; Goran Stankovic; Miodrag C Ostojic; Branko D Beleslin Journal: J Clin Med Date: 2021-12-30 Impact factor: 4.241