Transthoracic Doppler Echocardiographic Evaluation Of Coronary Stenosis

Objectives: To evaluate the feasibility of transthoracic Doppler echocardiography (TTDE) for noninvasive detection of coronary flow.To explore the value of transthoracic Doppler echocardiography in the detection of coronary hemodynamic changes foe noninvasive assessment of the efficacy of coronary stenosis.Methods: We study 120 patients who underwent coronary angiography for the asessment of left anterior descending , right coronary artery and left circumflex artery flow with TTDE. We assessed the specificity, sensitivity of TTDE for coronary stenosis and compared the flow parameters among different stenosis groups.Results:(1) Antegrade flow was obtained by TTDE in patients without occlusion,Successfu1 detection rate in LAD , RCA and LCX were 98,66 and 54 respectively. Retrograde flow was obtained by TTDE in patients with occluded, successful detection rate in LAD and RCA were 70 and 71 respectively.(2) LAD, and RCA stenosis different groups diastolic peak flow velocity, the average diastolic blood flow velocity, time integration diastolic velocity, acceleration and diastolic by velocity, peak systolic and diastolic blood flow velocity ratio There was significant difference. The peak systolic flow velocity, the difference between the three groups was not significant. (3) Hemodynamic parameters of the LAD, and the RCA stenosis greater than 50%, the LAD diastolic peak flow velocity, acceleration, deceleration area under the ROC curve were 0.921,0.884,0.853. RCA diastolic peak flow velocity, acceleration, deceleration area under the ROC curve were 0.919,0.947,0.737. Local hemodynamic parameters judge LAD, and RCA stenosis greater than 75%, LAD diastolic peak flow velocity, acceleration, deceleration area under the ROC curve were 0.935,0.954,0.845. RCA diastolic peak flow velocity, acceleration, deceleration area under the ROC curve were 0.931,0.967,0.936. (4) When DSVR> 2.2, the LAD of greater than 50% stenosis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 83%, 85%, 88%, 74%, 81 %. When DSVR> 2.2, the right diagnosis of RCA stenosis greater than 50%, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 83%, 79%, 84%, 82%, 84%. DSVR> 2.8, LAD stenosis of more than 75%, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 85%, 83%, 62%, 94%, 84%. When DSVR> 2.5 as the criterion of the diagnosis RCA stenosis greater than 75%, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 89%, 85%, 52%, 96%, 86%. (5) The LAD and RCA distal occlusion reverse flow of its sensitivity (70%, 71%), specificity (100%, 100%) and accuracy (95%, 97% ), the positive predictive value (100%, 100%) and negative predictive value (94%, 96%).Conclusions: Transthoracic Doppler echocardiography can detect major epicardial coronary artery branches. Resting state of coronary artery stenosis diastolic blood parameters have changed significantly in the diagnosis of coronary stenosis is of great significance. When complete occlusion that reverse flow signal, reverse flow signal judge left anterior descending branch of severe coronary artery stenosis or occlusion of the specificity was 100%.