经胸多普勒超声心动图评估左乳内动脉移植血管通畅情况

Assessment of left internal mammary artery graft patency by transthoracic Doppler echocardiography.

作者信息

El-Masry Magdy M, Salama Mai M, Darwish Ahmed Z, Abd El-Aziz Osama

机构信息

Department of Cardiology, Tanta Faculty of Medicine, Egypt.

出版信息

Clin Cardiol. 2002 Nov;25(11):511-6. doi: 10.1002/clc.4960251107.

DOI:10.1002/clc.4960251107

PMID:12430781

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6654748/

Abstract

BACKGROUND

The successful application of noninvasive Doppler spectrum analysis has been reported for the hemodynamic assessment of LIMA graft after myocardial revascularization.

HYPOTHESIS

The objective of this study was to assess the utility of transthoracic Doppler echocardiography (TTE) in providing information on LIMA flow in patients after coronary artery bypass graft surgery.

METHODS

In all, 22 patients (aged 62 +/- 8 years) with LIMA graft to the left anterior descending (LAD) coronary artery who underwent coronary angiography were assessed using high-frequency (5 MHz) transthoracic Doppler echocardiography. They were compared with 25 patients with angina (control group A, aged 59 +/- 12 years), in whom an ungrafted LIMA was assessed, and with 17 patients (control group B, aged 59 +/- 9 years) with angiographically normal coronary arteries, in whom the LAD was assessed.

RESULTS

A biphasic pattern (systolic and diastolic) was recorded in all cases. In 14 patients with a normal graft or < 70% stenosis (Group 1) and in control group B, blood flow was maximal during diastole. In eight patients with severe graft stenosis > 70% (Group 2) and control group B, blood flow was maximal during systole, with low diastolic flow. The diastolic fraction of the velocity time integrals was 0.81 +/- 0.11 for Group 1 and 0.25 +/-0.06 for Group 2 (p < 0.05). A diastolic velocity time integral fraction < 0.5 predicted > 70% stenosis with a sensitivity and specificity of 100%. The ratio of systolic/diastolic peak velocities was 0.61 +/- 0.31 for Group 1 and 3.21 +/- 0.49 for Group 2 (p < 0.05). A systolic/diastolic peak velocity > 1 predicted stenosis > 70% with a sensitivity and specificity of 100 and 90%, respectively.

CONCLUSIONS

High-frequency TTE is a useful noninvasive method for detecting LIMA graft blood flow. Severe graft stenoses exhibited Doppler velocity patterns, which were different from those of patent grafts, or grafts with moderate stenoses.

摘要

背景

无创多普勒频谱分析已成功应用于心肌血运重建术后左内乳动脉（LIMA）移植物的血流动力学评估。

假设

本研究的目的是评估经胸多普勒超声心动图（TTE）在提供冠状动脉旁路移植术后患者LIMA血流信息方面的效用。

方法

总共对22例接受冠状动脉造影的、LIMA移植至左前降支（LAD）冠状动脉的患者（年龄62±8岁）使用高频（5兆赫）经胸多普勒超声心动图进行评估。将他们与25例心绞痛患者（A对照组，年龄59±12岁，评估未移植的LIMA）以及17例冠状动脉造影正常的患者（B对照组，年龄59±9岁，评估LAD）进行比较。

结果

所有病例均记录到双相模式（收缩期和舒张期）。在14例移植物正常或狭窄<70%的患者（第1组）以及B对照组中，舒张期血流最大。在8例严重移植物狭窄>70%的患者（第2组）以及B对照组中，收缩期血流最大，舒张期血流较低。第1组速度时间积分的舒张期分数为0.81±0.11，第2组为0.25±0.06（p<0.05）。舒张期速度时间积分分数<0.5预测狭窄>70%的敏感性和特异性均为100%。第1组收缩期/舒张期峰值速度之比为0.61±0.31，第2组为3.21±0.49（p<0.05）。收缩期/舒张期峰值速度>1预测狭窄>70%的敏感性和特异性分别为100%和90%。