Key result
Children with elevated right ventricular pressure had significantly reduced posterior descending coronary flow velocity reserve compared to controls with normal right ventricular pressure (1.87 vs 2.49, p<0.01).
Why the study?
Does transthoracic Doppler echocardiography detect reduced coronary flow velocity reserve in the posterior descending coronary artery in children with elevated right ventricular pressure compared to controls?
Observational (n=32)
No
Does transthoracic Doppler echocardiography detect reduced coronary flow velocity reserve in the posterior descending coronary artery in children with elevated right ventricular pressure compared to controls?
Transthoracic Doppler echocardiography demonstrates that children with elevated right ventricular pressure have reduced coronary flow velocity reserve in the posterior descending artery due to elevated resting flow velocity.
May support noninvasive coronary assessment in children with RV pressure overload; hypothesis-generating for outcomes and validation.
BACKGROUND: Advances in transthoracic Doppler echocardiography enable noninvasive measurements of coronary flow velocity and coronary flow velocity reserve (CFVR) in the posterior descending coronary artery (PD). METHODS AND RESULTS: To evaluate CFVR in the PD of children with elevated right ventricular (RV) pressure, 19 children with RV pressure overload and 13 age-matched controls with normal RV pressure were studied using transthoracic Doppler echocardiography. Average peak flow velocity (APV) was measured at rest and in hyperemic conditions (intravenous administration of adenosine of 0.16 mg.kg(-1).min(-1)). Compared with controls, the PD CFVR was significantly reduced in the patients with elevated RV pressure (1.87+/-0.42 vs 2.49+/-0.55, p<0.01) because their mean baseline APV was significantly greater (27+/-6 vs 19+/-4 cm/s, p<0.01), although hyperemic APV was not significantly different (49+/-10 vs 48+/-14 cm/s, p=NS). CONCLUSIONS: PD CFVR is limited in patients with elevated RV pressure because of elevation of the baseline resting flow velocity.
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Shimada et al. (2007) conducted an observational in Elevated right ventricular pressure (n=32). Elevated right ventricular pressure vs. Normal right ventricular pressure was evaluated on Posterior descending coronary flow velocity reserve (PD CFVR) (p=<0.01). Children with elevated right ventricular pressure had significantly reduced posterior descending coronary flow velocity reserve compared to controls with normal right ventricular pressure (1.87 vs 2.49, p<0.01).
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