Detects coronary stenosis with Doppler ultrasound

In his PhD thesis, Espen Holte has investigated if coronary artery disease can be diagnosed based on transthoracic Doppler echocardiography.


MAIN RESULTS:

  1. Transthoracic measurements of poststenotic diastolic-to-systolic velocity ratio in the left anterior descending coronary artery excluded and detected significant stenoses with high accuracy.
  2. Transthoracic measurements of peak stenotic to prestenotic velocity ratio had high specificity for detecting significant stenosis in the three main coronary arteries.

THESIS DEFENCE:

Thesis: Transthoracic Doppler echocardiography for the detection of coronary artery stenoses and microvascular coronary dysfunction
Candidate: Espen Holte
Time: November 17, 2017 at 12:15
Place: St. Olavs Hospital, Medical Technical Research Centre (Norwegian Brain Center): Auditorium MTA
Link to university website (in Norwegian)


SUMMARY:

(1) 108 patients scheduled for coronary angiography because of chest pain or acute coronary syndromes were examined with transthoracic Doppler-echocardiography. Analyses showed that peak poststenotic diastolic-to-systolic velocity ratio was significantly higher in lesions with lower diameter stenosis than 50%. The optimal cutoff value for identifying significant stenosis was calculated, and showed high accuracy to identify and exclude stenosis of the distal to mid left anterior descending coronary artery and marginal branches of the left circumflex coronary.

(2) In the same patients, peak stenotic to prestenotic velocity ratio showed better sensitivity to detect significant stenosis in the left main coronary artery and the left anterior descending coronary than in the left circumflex coronary and right coronary artery.


REFERENCES:

(1) Holte, E., Vegsundvåg, J., Hegbom, K., Hole, T., & Wiseth, R. (2013). Transthoracic Doppler echocardiography for detection of stenoses in the left coronary artery by use of poststenotic coronary flow profiles: a comparison with quantitative coronary angiography and coronary flow reserveJournal of the American Society of Echocardiography26(1), 77-85.

(2) Holte, E., Vegsundvåg, J., Hegbom, K., Hole, T., & Wiseth, R. (2015). Transthoracic Doppler for detection of stenoses in the three main coronary arteries by use of stenotic to prestenotic velocity ratio and aliased coronary flowEuropean Heart Journal-Cardiovascular Imaging16(12), 1323-1330.

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