Copyright © 2004, The European Society of Cardiology
Noninvasive assessment of coronary flow velocity reserve in left anterior descending artery adds diagnostic value to both clinical variables and dobutamine echocardiography: a study based on clinical practice
Hospital Universitario Virgen de la Arrixaca, Ctra. Madrid-Cartagena, 30120 El Palmar, Murcia, Spain
Received 4 May 2004; received in revised form 4 October 2004; accepted after revision 5 October 2004.
* Corresponding author. C/Historiador Torres Fontes,18;4°E, 30011 Murcia, Spain. Tel.: +34 968264510; fax: +34 968369662. E-mail: r_florenciano@hotmail.com
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Abstract |
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Aims Our objective was to evaluate, in clinical practice, whether noninvasive assessment of coronary flow velocity reserve in left anterior coronary artery adds diagnostic information to both clinical variables and wall motion abnormalities derived from dobutamine stress echocardiography.
Methods and results We studied 130 patients who were scheduled for coronary angiography after undergoing dobutamine stress echocardiography. The same day, flow in left anterior descending artery was detected by transthoracic Doppler echocardiography. A Doppler signal of left anterior descending artery was detected in 110 patients (85%). We identified significant left anterior descending artery stenosis (>50% diameter stenosis) in 42 patients. Sensitivity and specificity of abnormal coronary flow velocity reserve (<2) to detect left anterior descending artery stenosis were 86% and 57%, respectively. Wall motion abnormalities had a sensitivity and specificity of 52% and 82%. After forcing the clinical and dobutamine stress echo variables into a regression model with three modeling steps, an abnormal coronary flow velocity reserve provided incremental information in predicting significant left anterior descending artery stenosis.
Conclusion An abnormal coronary flow velocity reserve by transthoracic Doppler echocardiography adds diagnostic value to both clinical data and variables derived from dobutamine stress echo to detect significant left anterior descending artery stenosis.
Keywords: Coronary flow velocity reserve; Dobutamine stress echocardiography; Left anterior descending artery; Transthoracic Doppler echocardiography
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