Saraste Markku, Vesalainen Risto K, Ylitalo Antti, Saraste Antti, Koskenvuo Juha W, Toikka Jyri O, Vaittinen Mari-Anne, Hartiala Jaakko J, Airaksinen K E Juhani
Department of Clinical Physiology, Turku University Hospital, Turku, Finland.
J Am Soc Echocardiogr. 2005 Jun;18(6):679-85. doi: 10.1016/j.echo.2004.09.016.
We prospectively tested the diagnostic accuracy of Doppler transthoracic echocardiography in detection of coronary artery stenoses throughout the main coronary arterial tree. In all, 84 patients referred for diagnostic quantitative coronary angiography were studied. Coronary artery stenosis was identified with color Doppler as local spot of turbulence, and local flow velocity was measured using pulsed wave Doppler. Angiography showed significant stenoses (diameter reduction > 50%) in 33 patients. An abnormal maximal-to-prestenotic blood flow velocity ratio greater than 2.0 in subtotal stenoses, or the detection of collateral blood flow in the absence of normal antegrade flow in the case of total occlusion (N = 6), resulted in overall sensitivity of 82% and specificity of 92%. The sensitivity and specificity were, respectively, 73% and 92% for left anterior descending coronary artery, 63% and 96% for right coronary artery, and 38% and 99% for left circumflex coronary artery stenoses. Transthoracic echocardiography is a promising noninvasive technique to diagnose significant coronary artery stenoses.
我们前瞻性地测试了经胸多普勒超声心动图在检测整个主要冠状动脉树中冠状动脉狭窄方面的诊断准确性。总共对84例因诊断性定量冠状动脉造影而转诊的患者进行了研究。冠状动脉狭窄通过彩色多普勒被识别为局部湍流点，并使用脉冲波多普勒测量局部流速。血管造影显示33例患者存在明显狭窄（直径减少>50%）。在次全狭窄中，最大与狭窄前血流速度比大于2.0异常，或在完全闭塞（N = 6）的情况下，在无正常顺行血流时检测到侧支血流，总体敏感性为82%，特异性为92%。左前降支冠状动脉狭窄的敏感性和特异性分别为73%和92%，右冠状动脉狭窄的敏感性和特异性分别为63%和96%，左旋支冠状动脉狭窄的敏感性和特异性分别为38%和99%。经胸超声心动图是一种有前景的用于诊断明显冠状动脉狭窄的非侵入性技术。
