1992 Fiscal Year Final Research Report Summary
Noninvasive estimation of coronary stenotic lesion using two dimensional or Doppler echocardiograpy
| Project/Area Number |
02454258
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Circulatory organs internal medicine
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| Research Institution | Kagawa Medical School |
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Principal Investigator |
MATSUO Hirohide Kagawa Medical School, Second Department of internal Medicine, Professor, 医学部, 教授 (90028514)
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| Co-Investigator(Kenkyū-buntansha) |
HIRABAYASHI Koichi Kagawa Medical School, Second Department of internal Medicine, Research Associat, 医学部, 助手 (80240894)
FUKADA Hidetoshi Kagawa Medical School, Second Department of internal Medicine, Research Associat, 医学部・附属病院, 助手 (20211518)
NAKAJIMA Shigeru Kagawa Medical School, Second Department of internal Medicine, Research Associat, 医学部・附属病院, 助手 (80172310)
MORITA Hisaki Kagawa Medical School, Second Department of internal Medicine, Assistant Profess, 医学部・附属病院, 講師 (70145051)
SENDA Syoichi Kagawa Medical School, Second Department of internal Medicine, Assistant Profess, 医学部・附属病院, 助教授 (30145049)
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| Project Period (FY) |
1990 – 1992
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| Keywords | Transesophageal Doppler echocardiography / Coronary stenosis / Transpulmonary contrast agents / Color Doppler method / Coronary intervension |
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| Research Abstract |
First, we found the acceleration phenomenon of peak blood flow velocity at left main trank (LMT) or proximal left desccending artery (LAD) stenosis using transesophageal pulsed Doppler echocardiography. This phenomenon allowed us to diagnose the stenosis in those arteries. Transesophageal color Doppler or pulsed Doppler echocardiography combined with the injection of ultrasound contrast agents passing through the pulmonary vascular bed into the peripheral veins enhanced the detection of the acceleration phenomenon. However, acceleration phenomenon was observed at less than 50% stenosis, thus false positive was occured. Therefore, we examined the problems of acceleration phenomenon in diagnosing coronary stenosis and also examined whether the siverity of coronary stenosis correlated with the acceleration ratio of the coronary flow velocity at the stenotic site. The coronary flow velocity accelerated more than twice at the stenotic site compared with the pre-stenotic site in over 90% of patients with over 75% stenosis, thus "more than twice acceleration of coronary flow velocity" could be a specific criterion for diagnosing significant coronary stenosis. The siverity coronary stenosis was not proportionate to the acceleration ratio of the coronary flow velocity. The reason was speculated that the pulsed Doppler method cann't always detect the highest velocity at the stenosis.
However, the acceleration ratio was available for estimating a change in the siverity of coronary stenosis in each indivisual patient. Since proximal LAD stenosis is a common target of coronary intervention, transesophageal Doppler echocardiography may be a useful tool for following up the proximal LAD lesions for which coronary intervention was undergone.
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