Assessment of coronary reserve by transoesophageal Doppler echocardiography: Direct comparison between different modalities of dipyridamole and adenosine administration
| Autor: | Lorenza Pratali, Antonio L'Abbate, Carlo Palombo, Mario Marzilli, G. Bigalli, M. Kozàkovà, A Distante |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
Male medicine.medical_specialty Adenosine Vasodilator Agents Coronary Disease Doppler echocardiography Coronary artery disease Left coronary artery Coronary Circulation medicine.artery Internal medicine Infusion Procedure medicine Humans Infusions Intravenous medicine.diagnostic_test business.industry Hemodynamics Dipyridamole Middle Aged medicine.disease Coronary Vessels Echocardiography Doppler medicine.anatomical_structure Injections Intravenous Vascular resistance Cardiology Female Coronary vasodilator Cardiology and Cardiovascular Medicine business Blood Flow Velocity Echocardiography Transesophageal medicine.drug |
| Zdroj: | European Heart Journal. 18:514-523 |
| ISSN: | 1522-9645 0195-668X |
| DOI: | 10.1093/oxfordjournals.eurheartj.a015274 |
| Popis: | Background This study was undertaken to compare the coronary vasodilator response to different application modalities of intravenous vasodilators, in order to identify the optimal pharmacological protocol for the evaluation of coronary reserve by means of transoesophageal Doppler echocardiography. Methods Blood flow velocity in the left anterior descending artery, coronary vascular resistance and left main coronary artery cross-sectional area were assessed by transoesophageal echo-Doppler during an i.v. adenosine bolus (5 mg), a 5-min adenosine infusion (infusion rate 140μg.kg−1.min−1), and low (0·56mg.kg−1.min−1), and high-dose (0·84mg.kg−1.9min−1) dipyridamole infusions in 10 healthy normals (Group 1) and in 20 patients (Group 2) with either coronary microvascular disease (11 patients) or coronary artery disease (nine patients). Results In both groups, the highest flow velocity and the lowest coronary vascular resistance were observed during the adenosine infusion. Flow velocity values and indices of coronary vasodilator capacity observed after the adenosine bolus and the high-dose dipyridamole infusion were very close to those obtained during the adenosine infusion, especially in Group 1. Coronary flow velocity was lower and coronary vascular resistance higher after low-dose dipyridamole, significantly in Group 2. The maximal flow response to the adenosine bolus was observed within a few seconds after the injection, and was very short. The peak response to the adenosine infusion was observed 57±27 s after its start. The coronary flow velocity response to dipyridamole was dose dependent and differed between Groups 1 and 2. Conclusion In combination with transoesophageal Doppler echocardiography, a short-lasting adenosine infusion at a rate of 140μg.kg−1.min−1 seems to be preferable to an adenosine bolus and dipyridamole infusion. The effect of the bolus is too short for an accurate measurement of coronary flow velocity, while the dipyridamole infusion, especially at a low dose, induces a submaximal vasodilator response. |
| Databáze: | OpenAIRE |
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