Detection of Restenosis After Percutaneous Coronary Intervention in Three Major Coronary Arteries by Transthoracic Doppler Echocardiography

Hyodo, Eiichi; Hirata, Kumiko; Hirose, Makoto; Sakanoue, Yuji; Nishida, Yukio; Arai, Kotaro; Kawarabayashi, Takahiko; Shimada, Kenei; Hozumi, Takeshi; Muro, Takashi; Homma, Shunichi; Yoshikawa, Junichi; Yoshiyama, Minoru

doi:10.1016/j.echo.2010.03.007

« Previous Next »Journal of the American Society of Echocardiography
Volume 23, Issue 5 , Pages 553-559, May 2010

Detection of Restenosis After Percutaneous Coronary Intervention in Three Major Coronary Arteries by Transthoracic Doppler Echocardiography

Eiichi Hyodo, MD
- Department of Internal Medicine and Cardiology, Osaka City University Medical School, Osaka, Japan
- Reprint requests: Eiichi Hyodo, MD, Osaka City University Medical School, Department of Internal Medicine and Cardiology, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
Kumiko Hirata, MD
- Department of Cardiovascular Medicine, Wakayama Medical College, Wakayama, Japan
Makoto Hirose, MD
- Department of Internal Medicine, Division of Cardiology, Higashisumisyoshi Morimoto Hospital, Osaka, Japan
Yuji Sakanoue, MD
- Department of Internal Medicine, Division of Cardiology, Higashisumisyoshi Morimoto Hospital, Osaka, Japan
Yukio Nishida, MD
- Department of Internal Medicine, Division of Cardiology, Higashisumisyoshi Morimoto Hospital, Osaka, Japan
Kotaro Arai, MD
- Division of Cardiology, Columbia University Medical Center, New York, New York
Takahiko Kawarabayashi, MD
- Department of Internal Medicine, Division of Cardiology, Higashisumisyoshi Morimoto Hospital, Osaka, Japan
Kenei Shimada, MD
- Department of Internal Medicine, Division of Cardiology, Osaka Ekisaikai Hospital, Osaka, Japan
Takeshi Hozumi, MD
- Department of Internal Medicine and Cardiology, Osaka City University Medical School, Osaka, Japan
Takashi Muro, MD
- Department of Internal Medicine and Cardiology, Osaka City University Medical School, Osaka, Japan
Shunichi Homma, MD
- Division of Cardiology, Columbia University Medical Center, New York, New York
Junichi Yoshikawa, MD
- Department of Internal Medicine, Division of Cardiology, Osaka Ekisaikai Hospital, Osaka, Japan
Minoru Yoshiyama, MD
- Department of Internal Medicine and Cardiology, Osaka City University Medical School, Osaka, Japan

Background

The aim of this study was to evaluate the diagnostic potential of coronary flow velocity reserve (CFR) measurement by transthoracic Doppler echocardiography (TTDE) to detect restenosis in the 3 major coronary arteries: the left anterior descending coronary artery, right coronary artery, and left circumflex coronary artery.

Methods

The lesions of 175 patients who were scheduled for follow-up coronary angiography and TTDE 6 months after undergoing stents implantation were studied. CFR was assessed by TTDE in the targeted arteries into which stents had been implanted.

Results

Coronary stents were implanted in a total of 238 angiographic lesions in 175 patients. Doppler recordings of coronary flow in the 3 major arterial lesions were obtained in 211 of the 238 angiographic lesions (89% feasibility). CFR was significantly lower in lesions with restenosis than those without restenosis (1.70 ± 0.32 vs 2.65 ± 0.66, P < .01). A CFR value < 2.0 was 89% sensitive and 91% specific for detecting restenosis in the 3 major coronary arteries. Sensitivity and specificity were 86% and 91%, respectively, in the left anterior descending coronary artery (95% feasibility); 92% and 92%, respectively, in the right coronary artery (85% feasibility); and 91% and 92%, respectively, in the left circumflex coronary artery (81% feasibility).

Conclusion

CFR assessment by TTDE is an accurate method for monitoring restenosis, not only in the left anterior descending but also in the right and left circumflex coronary arteries in patients previously subjected to percutaneous coronary intervention.

Keywords: Coronary flow velocity reserve, Restenosis, Echocardiography, Coronary artery disease

Abbreviations: CFR, Coronary flow velocity reserve, LAD, Left anterior descending coronary artery, LCX, Left circumflex coronary artery, PCI, Percutaneous coronary intervention, RCA, Right coronary artery, TTDE, Transthoracic Doppler echocardiography