Analysis of Coronary Artery Flow Patterns in Patients with Chest Pain and Normal Coronary Angiogram: Study Using Transthoracic Doppler Echocardiography.
10.4070/kcj.2003.33.3.205
- Author:
Ho Joong YOUN
1
;
Chul Soo PARK
;
Eun Ju CHO
;
Hae Ok JUNG
;
Sang Hyun IHM
;
Hui Kyung JEON
;
Yong Seok OH
;
Wook Sung CHUNG
;
Jang Seong CHAE
;
Jae Hyung KIM
;
Kyu Bo CHOI
;
Soon Jo HONG
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Chest pain;
Blood flow velocity;
Echocardiography, Doppler
- MeSH:
Anemia;
Angiotensin Amide;
Angiotensin II;
Blood Flow Velocity;
Chest Pain*;
Coronary Vessels*;
Depression;
Dipyridamole;
Echocardiography, Doppler*;
Electrocardiography;
Female;
Humans;
Hypertension;
Hyperthyroidism;
Thorax*
- From:Korean Circulation Journal
2003;33(3):205-211
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: The purpose of this study was to analyze the patterns of coronary artery flow, using transthoracic Doppler echocardiography(TE), in subjects with chest pains and normal coronary angiograms. SUBJECTS AND METHODS: 93 patients(M:F=34:59, mean age:57+/-11 years) ith chest pains and normal coronary angiograms were included in this study. After obtaining baseline clinical data, an exercise treadmill test(TT) as performed, according to the Bruce protocol. The peak diastolic coronary artery flow velocity(DV), at rest, and the coronary flow reserve(FR), in the distal left anterior descending coronary artery(AD), were estimated, using dipyridamole, with TTE. After the administration of angiotensin II receptor(AT II) lockers to 12 patients with a CFR <2.1. The ETT and CFR were followed up. RESULTS: Of the 93 subjects 63(7.7%) ere female, and 53(6.9%) ad a history of hypertension and 61(5.5%) howed ST or T abnormality on their resting ECG. Five subjects(30.3%) ad metabolic or hematologic problems, such as hyperthyroidism or anemia. Twenty-seven(0.3%) of the 89 subjects showed a reduced CFR value less than 2.1. The subjects with horizontal or down-sloping ST depression on their ETT showed a decreased CFR, compared with those with no ST shifting or an up-sloping ST depression(<0.05, respectively). Twenty-six(7.9%) f the 93 subjects showed a slow coronary flow velocity <14 cm/sec, and 15(3.3%) f 18 subjects who estimated CFR had CFR > or =2.1. In 7(8.3%) of 12 subjects with a CFR <2.1, their CFR increased, with an improvement of the ETT results, following the administration of the AT II blocker, after an average 19+/-9 months. CONCLUSION: The patients with chest pains and normal coronary angiograms have a heterogeneous clinical spectrum, such as hypertensin, slow flow, reduced CFR, and so on. These subjects need treatment according to the etiology and pathogenesis of their condition, which can be followed up by coronary flow measurements, using TTE.
