Abstract
To evaluate whether transthoracic Doppler echocardiography can reliably measure coronary flow velocity and coronary flow velocity reserve (CFVR) in the posterior descending coronary artery (PD) in children, we examined 32 patients who had congenital heart disease (ventricular septal defect in 10, tetralogy of Fallot in 6, tricuspid atresia in 3, double-outlet right ventricle in 2, patent ductus arteriosus in 2, and aortic valve stenosis in 2) and 7 patients who had a history of Kawasaki disease without stenosis or aneurysm formation of the coronary artery. Average peak flow velocity (APV) in the PD was measured by transthoracic Doppler echocardiography at the time of intracoronary Doppler study. CFVR was defined as the ratio of hyperemic to basal APV. Clear envelopes of basal and hyperemic APV in the PD were obtained in 23 of 32 patients by transthoracic Doppler echocardiography. APV obtained from transthoracic Doppler echocardiography correlated highly with that from the Doppler guidewire method (r = 0.91). The mean difference between transthoracic Doppler echocardiography and the Doppler guidewire method was 0.1 ± 2.9. There was an excellent correlation between transthoracic Doppler echocardiography and the Doppler guidewire method for the measurements of CFVR (r = 0.84). The mean difference between transthoracic Doppler echocardiography and Doppler guidewire was −0.016 ± 0.198. Noninvasive measurement of coronary flow velocity and CFVR in the PD using transthoracic Doppler echocardiography accurately reflects invasive measurement of coronary flow velocity and CFVR by the Doppler guidewire method in pediatric patients with various heart diseases.
Similar content being viewed by others
References
M Aoki K Harada G Takada (2003) ArticleTitleNoninvasive visualization and measurement of pesterior descending coronary artery flow velocity by transthoracic Doppler echocardiography in normal children Am J Cardiol 91 376–379
FM Bengel M Hauser CS Duvernoy et al. (1998) ArticleTitleMyocardial blood flow and coronary flow reserve late after anatomical correction of transposition of the great arteries J Am Coll Cardiol 32 1955–1961 Occurrence Handle10.1016/S0735-1097(98)00479-3 Occurrence Handle1:STN:280:DyaK1M%2FntlGruw%3D%3D Occurrence Handle9857878
JM Bland DG Altman (1986) ArticleTitleStatistical methods for assessing agreement between two methods of clinical measurements Lancet 1 307–310 Occurrence Handle1:STN:280:BimC3MjhvFc%3D Occurrence Handle2868172
JP Donnelly DM Paffel BL Shulkin et al. (1998) ArticleTitleResting coronary flow and coronary flow reserve in human infants after repair of palliation of congenital heart defects as measured by positron emission tomography J Thorac Cardiovasc Surg 115 103–110
K Hamaoka Z Onouchi Y Kamiya K Sakata (1998) ArticleTitleEvaluation of coronary flow velocity dynamics and flow reserve in patients with Kawasaki disease by means of a Doppler guide wire J Am Coll Cardiol 31 833–840 Occurrence Handle10.1016/S0735-1097(98)00019-9 Occurrence Handle1:STN:280:DyaK1c7osVClug%3D%3D Occurrence Handle9525556
K Hamaoka Z Onouchi Y Ohmochi (1992) ArticleTitleCoronary flow reserve in children with Kawasaki disease without angiographic evidence of coronary stenosis Am J Cardiol 69 691–692
K Harada T Orino C Hironaka Y Takahashi G Takada (1999) ArticleTitleCoronary blood flow velocity in normal infants and young adults assessed by transthoracic echocardiography Am J Cardiol 83 1583–1985
K Harada M Tamura Y Takahashi G Takada (2001) ArticleTitleCoronary blood flow assessed by transthoracic echocardiography in neonates Pediatr Cardiol 22 189–193
K Harada M Tamura M Toyono G Takada (2001) ArticleTitleNoninvasive visualization and measurement of great cardiac vein flow by transthoracic Doppler echocardiography in normal children Am J Cardiol 88 710–713
K Harada M Tamura M Toyono G Takada (2002) ArticleTitleTransthoracic Doppler echocardiographic measurement of flow velocity and flow velocity reserve in the great cardiac vein and in the left anterior descending coronary artery in children with left ventricular volume overload secondary to ventricular septal defect Am J Cardiol 89 1129–1133
K Harada M Toyono M Tamura (2003) ArticleTitleEffects of balloon valvuloplasty on left anterior descending coronary artery blood flow in a neonate with critical aortic stenosis with transthoracic Doppler echocardiography J Am Soc Echocardiogr 16 88–90 Occurrence Handle12514642
K Harada K Yasuoka M Tamura M Toyono (2002) ArticleTitleCoronary flow reserve assessment by Doppler echocardiography in children with and without congenital heart defect: comparison with invasive technique J Am Soc Echocardiogr 15 1121–1126
M Hauser FM Bengel A Kuhn et al. (2001) ArticleTitleMyocardial blood flow and flow reserve after coronary reimplantation in patients after arterial switch and Ross operation Circulation 103 1875–1880
ZM Hijazi JE Udelson H Snapper et al. (1994) ArticleTitlePhysiologic significance of chronic coronary aneurysms in patients with Kawasaki disease J Am Coll Cardiol 24 1633–1638 Occurrence Handle1:STN:280:ByqD2M3hsFU%3D Occurrence Handle7963108
M Iemura M Ishii T Sugimura T Akagi H Kato (2000) ArticleTitleLong term consequences of regressed coronary aneurysms after Kawasaki disease: vascular wall morphology and function Heart 83 3071–311 Occurrence Handle10.1136/heart.83.3.307
SB Jureidini CJ Marino GK Singh A Fiore IC Balfour (2000) ArticleTitleMain coronary artery and coronary ostial stenosis in children: detection by transthoracic color flow and pulsed Doppler echocardiography J Am Soc Echocardiogr 13 255–263
SB Jureidini CJ Marino B Waterman et al. (1998) ArticleTitleTransthoracic Doppler echocardiography of normally originating coronary arteries in children J Am Soc Echocardiogr 11 409–420
SB Jureidini GK Singh CJ Marino AC Fiore (2000) ArticleTitleAberrant origin of the left coronary artery from the right aortic sinus: surgical intervention based on echocardiographic diagnosis J Am Soc Echocardiogr 13 1117–1120
N Noto K Karasawa M Ayusawa et al. (2002) ArticleTitleNoninvasive assessment of coronary flow reserve in children with Kawasaki disease Heart 87 559–565 Occurrence Handle10.1136/heart.87.6.559 Occurrence Handle1:STN:280:DC%2BD383nsVGitw%3D%3D Occurrence Handle12010941
G Oskarsson E Pesonen P Munkhammar S Sandstom P Jogi (2002) ArticleTitleNormal coronary flow reserve after arterial switch operation for transposition of the great arteries An intracoronary Doppler guidewire study. Circulation 106 1696–1702
H-P Tries H Lambertz H Lethen (2002) ArticleTitleTransthoracic echocardiographic visualization of coronary artery blood flow and assessment of coronary flow reserve in the right coronary artery: a first report of 3 patients J Am Soc Echocardiogr 15 39–42
Y Ueno Y Nakamura H Takashima M Kinoshita A Soma (2002) ArticleTitleNoninvasive assessment of coronary flow velocity and coronary flow velocity reserve in the right coronary artery by transthoracic Doppler echocardiography: comparison with intracoronary Doppler guidewire J Am Soc Echocardiogr 15 1074–1089
P Voci F Pizzuto (2001) ArticleTitleImaging of the posterior descending coronary artery The last frontier in echocardiography. Ital Heart J 2 418–422
RF Wilson DE Laughlin PH Ackell et al. (1985) ArticleTitleTransluminal subselective measurement of coronary artery blood flow velocity and vasodilator reserve in man Circulation 72 82–92
K Yasuoka K Harada M Tamura G Takada (2002) ArticleTitleLeft anterior descending coronary artery flow and its relation to age in children J Am Soc Echocardiogr 15 69–75
K Yasuoka K Harada M Tamura G Takada (2002) ArticleTitleBlood flow in left anterior descending coronary artery in children with ventricular septal defect J Am Soc Echocardiogr 15 807–813
RW Yates PK Marsden RD Badawi et al. (2000) ArticleTitleEvaluation of myocardial perfusion using positron emission tomography in infants following a neonatal arterial switch operation Pediatr Cardiol 21 111–118
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Aoki, M., Harada, K., Tamura, M. et al. Posterior Descending Coronary Artery Flow Reserve Assessment by Doppler Echocardiography in Children with and without Congenital Heart Defect Comparison with Invasive Technique. Pediatr Cardiol 25, 647–653 (2004). https://doi.org/10.1007/s00246-004-0648-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00246-004-0648-y