Comparison of intracoronary Doppler guide wire and transesophageal echocardiography in measurement of flow velocity and coronary flow reserve in the left anterior descending coronary artery

Abstract

Background: The intracoronary Doppler tipped guide wire has been shown to be highly accurate in the measurement of coronary flow velocity (CFV). Recent studies have indicated that blood flow velocity in the left anterior descending coronary artery (LAD) can be determined by transesophageal echocardiography (TEE). The purpose of this study was to compare flow velocity recordings and coronary flow reserve measurements in the LAD by TEE with those obtained by Doppler guide wire.

Methods and results: The study population consisted of 14 patients with chest pain and normal coronary arteriograms. After routine coronary arteriography was performed, a 0.014-inch Doppler guide wire was advanced into the proximal part of the LAD. After baseline measurement of coronary flow velocity (CFV) was obtained, 140 microg/kg/min adenosine was administered intravenously for 3 minutes, and the flow velocity was recorded. TEE was performed within 24 hours of the cardiac catheterization. After baseline measurements of CFV in the LAD, heart rate, and blood pressure were obtained, 140 microg/kg/min adenosine was administered intravenously, and the CFV was recorded. Coronary flow reserve was calculated as the ratio of the peak diastolic CFV during adenosine infusion to the peak diastolic CFV at baseline. A good correlation was found (r = 0.91, p < 0.0001) between CFV by Doppler guide wire and that determined by TEE. A good correlation was also found between the coronary flow reserve assessed by Doppler guide wire and that determined by TEE (r = 0.92, p < 0.0001).

Conclusion: Our data indicate that CFV and coronary flow reserve in the LAD can be accurately measured by transesophageal echocardiography.