Differences in coronary artery blood velocities in the setting of normal coronary angiography and normal stress echocardiography
Abstract:
Overview
Background. Normal left anterior descending (LAD) coronary artery as determined by coronary angiography is considered not only to reflect normal angiography but also to correlate with normal anatomy and function. However, subjects who undergo coronary angiography may differ from those who do not need to have invasive evaluation even if their functional noninvasive studies like dobutamine stress echocardiography (DSE) were normal. Aim. LAD velocities in subjects with normal angiography and those with normal DSE are equal. Methods. A total of 244 subjects were evaluated, 78 had normal LAD by angiography and 166 had normal LAD by DSE. All had Doppler sampling of LAD velocities by transthoracic echocardiography. Results. Velocity was higher in the angiographic subgroup in diastole 41 ± 23 vs 33 ± 14 cm/s, p = 0.0078; systole 18 ± 14 vs 13 ± 7 cm/s, p = 0.012; diastolic integral 12.6 ± 5 vs 9.8 ± 3.8 cm, p = 3.15 × 10-5; systolic velocity integral 4 ± 2.9 vs 2.8 ± 1.9, p = 0.0014. While heart rate was similar in both groups, the product of diastolic velocity integral and heart rate of the LAD in the angiographic group was higher: 902 ± 450 vs 656 ± 394, p = 0.00599. Diastolic velocity deceleration time was similar in both groups. Coronary flow reserve defined as diastolic velocity ratio before and immediately after DSE correlated negatively with baseline velocity, r = -0.4. Conclusions. Mode of defining normality of coronary artery affects velocity behavior of the vessel, reflecting functional differences possibly related to microvasculature and vasodilatation.
Keywords
Coronary angiography, Dobutamine stress echocardiography, Doppler, Left anterior descending coronary artery
Article:
Article Information:
Disclosure
Financial support: No grants or funding have been received for this
study.
Correspondence
Dawod Sharif, MD Department of Cardiology Bnai Zion Medical Center 47 Golomb St, Haifa, Israel dawod.sharif@b-zion.org.il
