经胸多普勒超声心动图检测冠状动脉左前降支高度狭窄

Detection of high degree stenosis of left anterior descending coronary artery with transthoracic Doppler echocardiography

目的评价经胸多普勒超声心动图技术(TTDE)检测冠状动脉左前降支近、中段高度狭窄的准确性。方法85例临床怀疑为冠心病的患者,在冠状动脉造影术前24h内用TTDE探测左前降支血流。结果冠状动脉造影证实20例患者冠状动脉显著狭窄,其中7例为近、中段高度狭窄(≥95%)。73例患者(85.9%)超声检出左前降支血流,其中5例为逆向血流。该5例患者均为左前降支近、中段高度狭窄或完全阻塞。TTDE显示左前降支为逆向血流时,预测左前降支近、中段高度狭窄的敏感性和特异性分别为71.4%和100%。结论TTDE检出左前降支逆向血流是预测左前降支近、中段高度狭窄的一种准确、无创的新方法。

Objective To evaluate the accuracy of detecting high degree stenosis of proximal or mid-left anterior descending coronary artery(LAD) by transthoracic Doppler echocardiography(TTDE). Methods Eighty-five patients suspected of having coronary artery disease were examined 24 hours before coronary angiographic examination by TTDE, to detect blood flow in the LAD. Results Coronary angiography showed that 20 patients had significant LAD stenosis, among which 7 patients had proximal or mid-LAD high degree stenosis (≥95%). Adequate spectral Doppler recordings of coronary flow in the LAD were obtained in 73 patients,among which 5 patients had a retrograde LAD flow. All the 5 patients had a high degree proximal or mid-LAD stenosis. Thus, retrograde LAD flow had a sensitivity of (71.4)% and a specificity of 100% for detecting high degree stenosis of proximal or mid-LAD. Conclusions Retrograde flow in the LAD shown by TTDE is a useful noninvasive index for detecting high degree proximal or mid-LAD stenosis or occlusion.