经胸多普勒超声心动图检测三大冠状动脉经皮冠状动脉介入治疗后的再狭窄。

Detection of restenosis after percutaneous coronary intervention in three major coronary arteries by transthoracic Doppler echocardiography.

机构信息

Department of Internal Medicine and Cardiology, Osaka City University Medical School, Osaka, Japan.

出版信息

J Am Soc Echocardiogr. 2010 May;23(5):553-9. doi: 10.1016/j.echo.2010.03.007.

DOI:10.1016/j.echo.2010.03.007

PMID:20451804

Abstract

BACKGROUND

The aim of this study was to evaluate the diagnostic potential of coronary flow velocity reserve (CFR) measurement by transthoracic Doppler echocardiography (TTDE) to detect restenosis in the 3 major coronary arteries: the left anterior descending coronary artery, right coronary artery, and left circumflex coronary artery.

METHODS

The lesions of 175 patients who were scheduled for follow-up coronary angiography and TTDE 6 months after undergoing stents implantation were studied. CFR was assessed by TTDE in the targeted arteries into which stents had been implanted.

RESULTS

Coronary stents were implanted in a total of 238 angiographic lesions in 175 patients. Doppler recordings of coronary flow in the 3 major arterial lesions were obtained in 211 of the 238 angiographic lesions (89% feasibility). CFR was significantly lower in lesions with restenosis than those without restenosis (1.70 +/- 0.32 vs 2.65 +/- 0.66, P < .01). A CFR value < 2.0 was 89% sensitive and 91% specific for detecting restenosis in the 3 major coronary arteries. Sensitivity and specificity were 86% and 91%, respectively, in the left anterior descending coronary artery (95% feasibility); 92% and 92%, respectively, in the right coronary artery (85% feasibility); and 91% and 92%, respectively, in the left circumflex coronary artery (81% feasibility).

CONCLUSION

CFR assessment by TTDE is an accurate method for monitoring restenosis, not only in the left anterior descending but also in the right and left circumflex coronary arteries in patients previously subjected to percutaneous coronary intervention.

摘要

背景

本研究旨在评估经胸多普勒超声心动图（TTDE）测量冠状动脉血流储备（CFR）在检测 3 大冠状动脉（左前降支、右冠状动脉和左旋支冠状动脉）再狭窄中的诊断潜力。

方法

研究了 175 例计划进行随访冠状动脉造影和 TTDE 的患者，这些患者在接受支架植入后 6 个月进行了研究。通过 TTDE 评估靶向血管内植入的支架的 CFR。

结果

在 175 例患者的 238 个血管造影病变中植入了冠状动脉支架。在 238 个血管造影病变中的 211 个病变中获得了 3 个主要动脉病变的冠状动脉血流多普勒记录（89%的可行性）。与无再狭窄病变相比，有再狭窄病变的 CFR 值明显降低（1.70±0.32 比 2.65±0.66，P<0.01）。CFR 值<2.0 对检测 3 大冠状动脉再狭窄的敏感性为 89%，特异性为 91%。在左前降支（95%的可行性）中，敏感性和特异性分别为 86%和 91%；在右冠状动脉（85%的可行性）中，敏感性和特异性分别为 92%和 92%；在左旋支冠状动脉（81%的可行性）中，敏感性和特异性分别为 91%和 92%。