经胸多普勒超声心动图测定远端与近端冠状动脉血流速度比值对诊断左冠状动脉近端狭窄的意义
Significance of the distal to proximal coronary flow velocity ratio by transthoracic Doppler echocardiography for diagnosis of proximal left coronary artery stenosis.
作者信息
Okayama Hideki, Nishimura Kazuhisa, Saito Makoto, Inoue Katsuji, Hiasa Go, Sumimoto Takumi, Ogimoto Akiyoshi, Ohtsuka Tomoaki, Shigematsu Yuji, Higaki Jitsuo
机构信息
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Toon, Japan.
出版信息
J Am Soc Echocardiogr. 2008 Jun;21(6):756-60. doi: 10.1016/j.echo.2007.08.052. Epub 2007 Oct 10.
OBJECTIVE
This study was designed to evaluate the significance of accelerated coronary flow velocity in the proximal left coronary artery by transthoracic Doppler echocardiography for detecting coronary stenosis.
METHODS
Seventy subjects with suspected coronary artery disease underwent successful coronary flow velocity measurement in both proximal and distal lesions by transthoracic Doppler echocardiography and coronary angiography.
RESULTS
On the basis of the coronary angiography results, 23 patients had significant (> or =50%) stenosis in the proximal left coronary artery (Group S) and 47 patients had no stenosis (Group N). The distal averaged diastolic peak velocity to proximal averaged diastolic peak velocity ratio (DAPAR) in Group S was significantly lower than that in Group N. A cutoff value of DAPAR < or = 0.5 for DAPAR predicted significant coronary stenosis with a sensitivity of 91% and a specificity of 72%.
CONCLUSION
Measurement of the DAPAR by transthoracic Doppler echocardiography is a promising method in the noninvasive diagnosis of stenosis in the proximal left coronary artery lesion.
目的
本研究旨在通过经胸多普勒超声心动图评估左冠状动脉近端血流速度加快在检测冠状动脉狭窄中的意义。
方法
70例疑似冠心病患者通过经胸多普勒超声心动图和冠状动脉造影成功测量了近端和远端病变处的冠状动脉血流速度。
结果
根据冠状动脉造影结果，23例患者左冠状动脉近端存在显著（≥50%）狭窄（S组），47例患者无狭窄（N组）。S组的远端平均舒张期峰值速度与近端平均舒张期峰值速度之比（DAPAR）显著低于N组。DAPAR≤0.5的截断值预测显著冠状动脉狭窄的敏感性为91%，特异性为72%。
结论
经胸多普勒超声心动图测量DAPAR是无创诊断左冠状动脉近端病变狭窄的一种有前景的方法。
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