Angiographically borderline left main coronary artery lesions: correlation of transthoracic doppler echocardiography and intravascular ultrasound: a pilot study

Cardiovascular Ultrasound

Research

Attila Pálinkás¹  Tamás Forster²  Zoltán Ruzsa²  Imre Ungi²  Albert Varga² 

[1] Department of Internal Medicine, Erzsébet Hospital, Hódmezővásárhely, Hungary;Department of Medicine and Cardiology Center, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, H-6724, Szeged Pécsi str. 4, Szeged, Hungary;

关键词: Fractional Flow Reserve;    Coronary Flow Reserve;    Plaque Burden;    Quantitative Coronary Angiography;    Leave Main;   

DOI  :  10.1186/1476-7120-9-19

 received in 2011-01-31, accepted in 2011-06-14,  发布年份 2011

来源: Springer

【 摘 要 】

Backgroundthe clinical decision making could be difficult in patients with borderline lesions (visually assessed stenosis severity of 30 to 50%) of the left main coronary artery (LM). The aim of the study was to evaluate the relationship between transthoracic Doppler (TTDE) peak diastolic flow velocity (PDV) and intravascular ultrasound (IVUS) measurements in the assessment of angiographically borderline LM lesions.Methods27 patients (mean age 64 ± 8 years, 21 males) with borderline LM stenosis referred for IVUS examination were included in the study. We performed standard IVUS with minimal lumen area (MLA) and plaque burden (PB) measurement and routine quantitative coronary angiography (QCA) with diameter stenosis (%DS) and area stenosis (%AS) assessment in all. During TTDE, resting PDV was measured in the LM.Resultsinterpretable Doppler signal could be obtained in 24 patients (88% feasibility); therefore these patients entered the final analysis. MLA was 7.1 ± 2.7 mm2. TTDE measured PDV correlated significantly with IVUS-derived MLA (r = -0.46, p < 0.05) and plaque burden (r = 0.51, p < 0.05). Using a velocity cut-off of 112 cm/sec TTDE showed a 92% sensitivity and 62% specificity to identify IVUS-significant (MLA < 6 mm2) LM stenosis.ConclusionIn angiographically borderline LM disease, resting PDV from transthoracic echocardiography is increased in presence of increased plaque burden by IVUS. TTDE evaluation might be a useful adjunct to other invasive and non-invasive methods in the assessment of borderline LM lesions. Further, large scale studies are needed to establish the exact cut-off value of PDV for routine clinical application.

【 授权许可】

Unknown   
© Ruzsa et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.