© 1997 by European Society of Cardiology
Copyright © 1997, European Society of Cardiology
Transesophageal versus intracoronary Doppler measurements for calculation of coronary flow reserve1
Department of Cardiology, University of Vienna, Währinger Gürtel 18-20 Vienna A-1090, Austria
* Corresponding author. Tel.: +43-140-400-4614; fax: +43-140-81148.
Objective: The present study was performed to compare coronary flow reserve by transesophageal Doppler echocardiography and intracoronary Doppler flow wire measurements in patients with LAD disease. Methods: 17 patients with various degree of LAD stenosis were studied. Intracoronary LAD Doppler measurements were performed at baseline and after intracoronary injection of 18 µg adenosine. Transesophageal coronary sinus and LAD Doppler measurements were performed at baseline and after intravenous dipyridamole (0.6 mg/kg/5 min). Coronary flow reserve was calculated as the ratio of hyperemic to baseline average peak velocities. Results: Coronary flow reserve was 2.44±0.62 and 2.19±0.76 for proximal and distal intracoronary measurements and was 2.25±0.64 and 1.74±0.63 for transesophageal LAD- and coronary sinus measurements. Proximal intracoronary flow reserve significantly correlated with transesophageal coronary sinus (r = 0.73, p
0.001) and LAD (r = 0.70, p0.005) measurements, whereas distal intracoronary flow reserve only correlated with transesophageal coronary sinus flow reserve (r = 0.56, p0.02). Receiver operating characteristic curve analysis demonstrated similar diagnostic accuracy of all applied techniques for detection of a significant LAD stenosis. Conclusions: Coronary flow reserve by both transesophageal techniques correlated with intracoronary Doppler flow wire measurements, however considerable discrepancies may occur in the individual patient.
KEYWORDS Coronary flow reserve; Transesophageal echocardiography; Intracoronary Doppler flow wire; Human; Coronary artery disease
1 This work was presented in part at the 68th Scientific Sessions of the American Heart Association in Anaheim, November 1995.
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