Esteban E, García-Fernández M A, González Torrecilla E, San Román D, Delcán J L
Departamento de Cardiología, Hospital General Gregorio Marañón, Madrid.
Rev Esp Cardiol. 1993 Jan;46(1):20-7.
Proximal coronary artery anatomy and coronary blood flow was evaluated by transesophageal echocardiography in 41 consecutive patients without coronary artery disease. The left main coronary artery was visualized in 37 patients (90%), the left anterior descending coronary artery in 20 (48%), the left circumflex artery in 16 (39%) and the right coronary artery in 7 (17%). The image quality was optimal in 58% of patients in left main coronary artery, 29% in left anterior descending coronary artery, 24% in left circumflex artery and 5% in right coronary artery. Transesophageal Pulsed Doppler echocardiography evaluation of blood flow velocity in the left coronary artery was obtained in 37% of patients. Velocity flow pattern was biphasic with greater diastolic component and smaller systolic one (average peak flow velocity of 47.5 +/- 16.6 cm/seg during diastole and 23.1 +/- 9.5 cm/seg during systole). Coronary blood flow was detected by transesophageal color Doppler echocardiography in 51% of patients in left main coronary artery, 24% in left anterior descending coronary artery, 19% in left circumflex artery and 2% in right coronary artery. We conclude that transesophageal echocardiography provides better and more accurate visualization of proximal coronary arteries than transthoracic echocardiography, but technical limitations still remain to detect and evaluate coronary artery anatomy and coronary blood flow in a large number of patients.
对41例无冠状动脉疾病的连续患者进行经食管超声心动图检查，以评估近端冠状动脉解剖结构和冠状动脉血流情况。37例患者（90%）可见左主干冠状动脉，20例（48%）可见左前降支冠状动脉，16例（39%）可见左旋支动脉，7例（17%）可见右冠状动脉。左主干冠状动脉患者中58%图像质量最佳，左前降支冠状动脉患者中29%最佳，左旋支动脉患者中24%最佳，右冠状动脉患者中5%最佳。37%的患者通过经食管脉冲多普勒超声心动图评估了左冠状动脉血流速度。血流速度模式为双相，舒张期成分较大，收缩期成分较小（舒张期平均峰值流速为47.5±16.6cm/秒，收缩期为23.1±9.5cm/秒）。51%的左主干冠状动脉患者、24%的左前降支冠状动脉患者、19%的左旋支动脉患者和2%的右冠状动脉患者通过经食管彩色多普勒超声心动图检测到冠状动脉血流。我们得出结论，与经胸超声心动图相比，经食管超声心动图能更好、更准确地显示近端冠状动脉，但在大量患者中检测和评估冠状动脉解剖结构及冠状动脉血流仍存在技术局限性。
