Detection of restenosis after percutaneous coronary intervention in three major coronary arteries by transthoracic Doppler echocardiography

• Published in: Journal of the American Society of Echocardiography Vol. 23; no. 5; p. 553
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: United States 01.05.2010
• Subjects: Aged; Angioplasty, Balloon - adverse effects; Blood Vessel Prosthesis - adverse effects; Coronary Restenosis - diagnostic imaging; Coronary Restenosis - etiology; Echocardiography, Doppler - methods; Female; Humans; Male; Prognosis; Reproducibility of Results; Sensitivity and Specificity; Stents - adverse effects; Treatment Outcome
• ISSN: 1097-6795
• DOI: 10.1016/j.echo.2010.03.007

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. 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. 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). 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.