The flow-function relationship in patients with chronic coronary artery disease and reduced regional function : a Doppler transesophageal and bidimensional transthoracic echocardiography study

• Published in: International journal of cardiac imaging 1999-08, Vol.15 (4), p.271-278
• Main Authors: BARONI, M, TORRES, M. A, MAFFEI, S, VARGA, A, TERRAZZI, M, BIAGINI, A, PICANO, E
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Blood Flow Velocity - drug effects; Blood Flow Velocity - physiology; Cardiovascular system; Case-Control Studies; Coronary Circulation - physiology; Coronary Disease - diagnostic imaging; Coronary Disease - physiopathology; Dipyridamole; Echocardiography, Doppler - methods; Echocardiography, Transesophageal; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Myocardial Contraction - drug effects; Myocardial Contraction - physiology; Ultrasonic investigative techniques; Vasodilator Agents; Ventricular Dysfunction, Left - physiopathology
• ISSN: 0167-9899; 1573-0743
• DOI: 10.1023/A:1006122725824

Infra-low dose dipyridamole allows one to selectively explore myocardial viability. Transesophageal echocardiography Doppler measurement of left anterior descending coronary artery flow at baseline and following dipyridamole is an efficient tool to assess coronary flow response. Aim of this study was to determine the flow-function relationship during coronary vasodilatory stress in patients with coronary artery disease and baseline dysfunction. Twelve patients with resting dyssynergies and 6 controls underwent assessment of regional function and of left anterior descending blood flow velocity. Flow and function were evaluated at rest and following infra-low dose dipyridamole (0.28 mg/Kg over 4 min). Controls showed a normal function at rest and after dipyridamole. Six patients ('Responders') with resting dyssynergies showed an improvement in segments of left anterior descending artery territory, whereas the other six ones ('Non-responders') showed no functional change. Controls and 'Responders' had similar values of resting peak diastolic left anterior descending artery flow velocity both at rest and after dipyridamole, whereas 'Non-responders' showed a blunted flow response to dipyridamole. Myocardial segments with a resting dysfunction and a contractile reserve more often exhibit a residual flow response, whereas segments with fixed pattern show a flat flow response during coronary vasodilator stress.