Noninvasive assessment of coronary microvascular function in patients with chest pain and angiographically normal coronary arteries using transthoracic Doppler echocardiography / 中华超声影像学杂志

ABSTRACT

Objective To validate the measurement of coronary flow velocity and coronary flow velocity reserve(CFVR) by transthoracic Doppler echocardiography(TTDE) compared with invasive intracoronary Doppler flow wire technique(ICD) and to evaluate changes in coronary flow dynamics due to microvascular dysfunction in the patients with angiographically normal coronary arteries and chest pain.Methods Coronary flow velocity was measured in the distal left anterior descending artery(LAD) in 35 patients by TTDE at baseline and during intravenous adenosine infusion of 140 ?g?kg -1 ?min -1 . CFVR, coronary vascular resistance(CVR) and minimal coronary vascular resistance index(CVRI) were analysed in the patients with angiographically normal coronary arteries and chest pain (group A, n =20) and compared to a control group (group B, n =15).Results Average peak velocity at baseline (APVb),average peak velocity at hyperemia (APVh) and CFVR determined from TTDE correlated closely with those from ICD measurements.CFVR was lower and CVRI was higher in group A than in group B.Conclusions Noninvasive TTDE provides reliable measurement of coronary flow velocity and CFVR in the distal LAD.Microvascular dysfunction existed in the patients with normal angiograms and chest pain.