Detection of significant left coronary artery stenosis by reduced transthoracic coronary sinus flow reserve

ABSTRACT

Currently available methods for measurement of coronary flow reserve are invasive, time consuming and need laboratory equipment and staff. So, the aim of this study was to demonstrate coronary sinus flow by transthoracic echocardiography and to determine the feasibility of using CSFR for the diagnosis of left coronary artery stenosis. This study comprised two groups; patients group which consisted of 30 patients with angiographically proven isolated LCA stenosis, and control group which consisted of 10 healthy volunteers. All patients and subjects were examined by echo Doppler to measure coronary sinus diameter and coronary sinus flow dynamics at baseline and again at peak dipyridamole infusion. CSFR was measured by both peak and volumetric methods. At baseline, the coronary sinus diameter and Doppler parameters showed insignificant difference between both groups [P> 0.05]. At peak dipyridamole, a significant increase in CS diameter was seen in both groups [P< 0.01] without significant difference in between [P > 0.05]. However, dipyridamole induced increase of velocity and volume characteristic of CS was marked in control group than in patients group [P< 0.001]. CSFRp and CSFRv showed a highly significant decrease in patients group than control group [P<0.001]. CSFR by peak or volumetric methods stenosis with high sensitivity, specificity and accuracy