Successful percutaneous coronary intervention significantly improves coronary sinus blood flow as assessed by transthoracic echocardiography

  • Radmila Lyubarova
  • William E. Boden
  • Steven A. Fein
  • Joshua Schulman-Marcus
  • Mikhail Torosoff
Original Investigation
  • 46 Downloads

Abstract

Background

Transthoracic echocardiography (TTE) has been used to assess coronary sinus blood flow (CSBF), which reflects total coronary arterial blood flow. Successful angioplasty is expected to improve coronary arterial blood flow. Changes in CSBF after percutaneous coronary intervention (PCI), as assessed by TTE, have not been systematically evaluated.

Hypothesis

TTE can be utilized to reflect increased CSBF after a successful, clinically indicated PCI.

Methods

The study cohort included 31 patients (18 females, 62 ± 11 years old) referred for diagnostic cardiac catheterization for suspected coronary artery disease and possible PCI, when clinically indicated. All performed PCIs were successful, with good angiographic outcome. CSBF per cardiac cycle (mL/beat) was measured using transthoracic two-dimensional and Doppler flow imaging as the product of coronary sinus (CS) area and CS flow time–velocity integral. CSBF per minute (mL/min) was calculated as the product of heart rate and CSBF per cardiac cycle. In each patient, CSBF was assessed prospectively, before and after cardiac catheterization with and without clinically indicated PCI. Within- and between-group differences in CSBF before and after PCI were assessed using repeated measures analysis of variance.

Results

Technically adequate CSBF measurements were obtained in 24 patients (77%). In patients who did not undergo PCI, there was no significant change in CSBF (278.1 ± 344.1 versus 342.7 ± 248.5, p = 0.36). By contrast, among patients who underwent PCI, CSBF increased significantly (254.3 ± 194.7 versus 618.3 ± 358.5 mL/min, p < 0.01, p-interaction = 0.03). Other hemodynamic and echocardiographic parameters did not change significantly before and after cardiac catheterization in either treatment group.

Conclusions

Transthoracic echocardiographic assessment can be employed to document CSBF changes after angioplasty. Future studies are needed to explore the clinical utility of this noninvasive metric.

Keywords

Coronary sinus blood flow Transthoracic echocardiography Percutaneous coronary intervention Coronary perfusion Coronary artery disease 

Notes

Compliance with ethical standards

Conflict of interest

Radmila Lyubarova, William Boden, Steven Fein, Joshua Schulman-Marcus, and Michail Torosoff declare that they have no conflicts of interest.

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Copyright information

© Japanese Society of Echocardiography 2017

Authors and Affiliations

  1. 1.Division of CardiologyAlbany Medical CollegeAlbanyUSA
  2. 2.Clinical Trials Network, VA New England Healthcare SystemBoston University School of MedicineBostonUSA

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