Angiographically borderline left main coronary artery lesions: correlation of transthoracic doppler echocardiography and intravascular ultrasound: a pilot studyReport as inadecuate




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Cardiovascular Ultrasound

, 9:19

First Online: 14 June 2011Received: 31 January 2011Accepted: 14 June 2011

Abstract

Backgroundthe clinical decision making could be difficult in patients with borderline lesions visually assessed stenosis severity of 30 to 50% of the left main coronary artery LM. The aim of the study was to evaluate the relationship between transthoracic Doppler TTDE peak diastolic flow velocity PDV and intravascular ultrasound IVUS measurements in the assessment of angiographically borderline LM lesions.

Methods27 patients mean age 64 ± 8 years, 21 males with borderline LM stenosis referred for IVUS examination were included in the study. We performed standard IVUS with minimal lumen area MLA and plaque burden PB measurement and routine quantitative coronary angiography QCA with diameter stenosis %DS and area stenosis %AS assessment in all. During TTDE, resting PDV was measured in the LM.

Resultsinterpretable Doppler signal could be obtained in 24 patients 88% feasibility; therefore these patients entered the final analysis. MLA was 7.1 ± 2.7 mm. TTDE measured PDV correlated significantly with IVUS-derived MLA r = -0.46, p < 0.05 and plaque burden r = 0.51, p < 0.05. Using a velocity cut-off of 112 cm-sec TTDE showed a 92% sensitivity and 62% specificity to identify IVUS-significant MLA < 6 mm LM stenosis.

ConclusionIn angiographically borderline LM disease, resting PDV from transthoracic echocardiography is increased in presence of increased plaque burden by IVUS. TTDE evaluation might be a useful adjunct to other invasive and non-invasive methods in the assessment of borderline LM lesions. Further, large scale studies are needed to establish the exact cut-off value of PDV for routine clinical application.

List of abbreviationsCFRcoronary flow reserve

DSdiameter stenosis

FFRfractional flow reserve

IVUSintravascular ultrasound

LMLeft main coronary artery

LADleft anterior descending artery

MLAminimum lumen area

PDVpeak diastolic velocity

QCAquantitative coronary angiography

TTEtransthoracic echocardiography

TEEtransoesophageal echocardiography

TTDEtransthoracic Doppler echocardiography.

Electronic supplementary materialThe online version of this article doi:10.1186-1476-7120-9-19 contains supplementary material, which is available to authorized users.

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Author: Zoltán Ruzsa - Attila Pálinkás - Tamás Forster - Imre Ungi - Albert Varga

Source: https://link.springer.com/article/10.1186/1476-7120-9-19







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