经食管多普勒冠状动脉血流储备测量与铊-201单光子发射计算机断层成像在评估左前降支狭窄中的比较。

Comparison of transesophageal Doppler coronary flow reserve measurements with thallium-201 single-photon emission computed tomography imaging in assessment of left anterior descending artery stenoses.

作者信息

Zehetgruber M, Mörtl D, Porenta G, Mundigler G, Christ G, Lengauer R, Stix G, Probst P, Maurer G, Sochor H, Siostrzonek P

机构信息

Department od Cardiology, University od Vienna, Wahringer Gurtel 18-20, Vienna, Austria.

出版信息

Clin Cardiol. 1998 Apr;21(4):247-52. doi: 10.1002/clc.4960210404.

DOI:10.1002/clc.4960210404

PMID:9562934

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6655278/

Abstract

BACKGROUND AND HYPOTHESIS

Recent studies demonstrate the feasibility of coronary flow reserve measurements by transesophageal echocardiographic (TEE) Doppler recordings of coronary sinus or left anterior descending (LAD) coronary artery flow velocity for detecting stenoses of the LAD artery. This study compares coronary flow reserve measurements by Doppler TEE with thallium-201 (201Tl) single-photon emission computed tomography (SPECT) in patients with proximal single-vessel LAD stenosis.

METHODS

Nineteen patients with various degrees of LAD stenosis (mean area stenosis 71 +/- 24%; range 24-96%) were studied. Area stenosis by quantitative coronary angiography was < 75% in 7 patients and > 75% in 12 patients. Transesophageal LAD and coronary sinus Doppler measurements were performed at baseline and after intravenous dipyridamole. Coronary flow reserve was calculated as the ratio of hyperemic to baseline average peak velocities. Predefined coronary flow reserve cut-off values of 1.8 for the coronary sinus method and of 2.0 for the LAD method were used for diagnosis of significant LAD stenosis. Results were compared with qualitative 201Tl dipyridamole SPECT.

RESULTS

Overall predictive accuracy for diagnosis of > 75% LAD stenosis was 79% for 201Tl SPECT, 77% for the transesophageal LAD and 79% for the transesophageal coronary sinus technique. Concordant results between 201Tl SPECT and the LAD and coronary sinus Doppler methods were observed in 79% and 71% of patients, respectively.

CONCLUSIONS

Thallium-201 SPECT and transesophageal Doppler assessment of coronary flow reserve have similar accuracy for diagnosing significant proximal LAD stenosis. Therefore, both transesophageal Doppler techniques might constitute another widely available, noninvasive method for assessment of left coronary artery disease, if disease location is proximal.

摘要

背景与假设

近期研究表明，经食管超声心动图（TEE）通过记录冠状窦或左前降支（LAD）冠状动脉血流速度来测量冠状动脉血流储备，对于检测LAD动脉狭窄具有可行性。本研究比较了多普勒TEE测量冠状动脉血流储备与201铊（201Tl）单光子发射计算机断层扫描（SPECT）在近端单支LAD狭窄患者中的应用。

方法

对19例不同程度LAD狭窄（平均面积狭窄71±24%；范围24 - 96%）的患者进行研究。通过定量冠状动脉造影，7例患者的面积狭窄<75%，12例患者的面积狭窄>75%。在基线状态及静脉注射双嘧达莫后进行经食管LAD和冠状窦多普勒测量。冠状动脉血流储备通过充血期与基线平均峰值速度之比计算得出。采用冠状窦法预定义的冠状动脉血流储备临界值为1.8，LAD法为2.0，用于诊断显著的LAD狭窄。将结果与定性的201Tl双嘧达莫SPECT进行比较。