Circulation, Vol 83, 61-69, Copyright © 1991 by American Heart Association
S Iliceto, V Marangelli, C Memmola and P Rizzon
Transesophageal echocardiography allows the evaluation of proximal coronary
artery anatomy and coronary blood flow velocity (CBFV). To assess the
potential of transesophageal echocardiography in evaluating CBFV and its
variations induced by coronary-active drugs, we studied 15 patients by
high-quality pulsed wave Doppler recordings of CBFV. In these patients,
transesophageal Doppler evaluation of CBFV was performed before, 2 minutes
after cessation of dipyridamole infusion (0.56 mg/kg in 4 minutes), and 2
minutes after aminophylline infusion (240 mg injected 4 minutes after
cessation of dipyridamole infusion). The following CBFV parameters were
evaluated at each of the three steps of the study protocol: maximal and
mean diastolic velocities and maximal and mean systolic velocities.
Furthermore, the following indexes of coronary flow reserve were evaluated:
the ratio between maximal diastolic velocity recorded after and before
dipyridamole administration and the ratio between mean diastolic velocity
recorded after and before dipyridamole administration. Nine of the 15
patients had a normal left anterior descending coronary artery (group A),
whereas the remaining six had significant (less than or equal to 75%)
stenosis (group B). In group A patients, all CBFV parameters increased
significantly during dipyridamole infusion and returned to near baseline
values after aminophylline infusion. In group B patients, on the other
hand, none of the CBFV parameters increased after dipyridamole infusion.
Dipyridamole/baseline maximal diastolic velocity and mean diastolic
velocity ratios were, respectively, 3.22 +/- 0.96 and 3.04 +/- 0.88 in
group A and 1.46 +/- 0.45 (p less than 0.01 versus group A) and 1.48 +/-
0.49 (p less than 0.01 versus group A) in group B patients.(ABSTRACT
TRUNCATED AT 250 WORDS)
ARTICLES
Transesophageal Doppler echocardiography evaluation of coronary blood flow velocity in baseline conditions and during dipyridamole-induced coronary vasodilation
Division of Cardiology, University of Bari, Italy.
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