@article{oai:dmu.repo.nii.ac.jp:00005116,
 author = {Ito, Nobuhiko and Harada, Osamu and Horinaka, Shigeo and Ishimitsu, Toshihiko},
 issue = {1},
 journal = {Dokkyo Medical Journal},
 month = {Mar},
 note = {Background: In coronary angiography (CAG), fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are widely measured for evaluating physiological ischemia and indication for percutaneous coronary intervention (PCI). On the other hand, the progress of ultrasonic devices and techniques have enabled the evaluation of coronary blood flow by non-invasive transthoracic echocardiography. Although, its application is limited to left anterior descending coronary artery (LAD).
　Objective: To investigate the correlation between the evaluation of physiological ischemia by catheterization and the evaluation of flow velocities by transthoracic echocardiography.
　Methods: In patients who underwent CAG for diagnosing angina, physiological evaluation of coronary blood flow was performed using pressure wire in LAD lesions. Transthoracic coronary echocardiography was also performed to evaluate the coronary blood flow velocity in the same lesions.
　Results: The peak diastolic flow velocity of the stenotic portion (V-stn) and the ratio of peak diastolic flow velocities of the stenotic and the reference portions (V-stn/V-ref) showed higher correlation efficient (r) values with FFR (r=0.561, p<0.001 and r=0.612, p<0.001, respectively) than with % diameter stenosis by quantitative CAG (r=0.481, p<0.001). On the other hand, iFR was also correlated with V-stn (r=0.411, p<0.001) but the correlation with V-stn/V-ref was not significant. According to the Receiver operating characteristic curve analysis, the V-stn and the V-stn/V-ref values corresponding to FFR=0.80 were 0.56 m/s (sensitivity 0.90, specificity 0.69) and 2.05 (sensitivity 0.85, specificity 0.69), respectively. Especially, almost all the patients with V-stn>1m/s or V-stn/V-ref >3 had FFR<0.80 and were sent for revascularization therapy.
　Conclusion: In LAD region of coronary artery, transthoracic coronary echocardiography is considered to be a practically useful method for evaluating physiological ischemia and indication for PCI.},
 pages = {22--29},
 title = {Evaluations of Left Anterior Descendant Coronary Artery Stenosis by Transthoracic Doppler Echocardiography as Compared with Physiological Parameters Measured by Pressure Wire},
 volume = {1},
 year = {2022}
}