Key result
Reduced antegrade coronary sinus blood flow (<220 mL/min) assessed by echocardiography predicted severe left coronary artery stenosis with 91.07% sensitivity and 87.76% specificity.
Why the study?
Does transthoracic Doppler echocardiography assessment of coronary sinus blood flow predict coronary artery stenosis in hypertensive patients?
Cross-Sectional (n=105)
Does transthoracic Doppler echocardiography assessment of coronary sinus blood flow predict coronary artery stenosis in hypertensive patients?
Transthoracic Doppler echocardiography measurement of reduced antegrade coronary sinus flow is a sensitive and specific non-invasive predictor of severe coronary artery stenosis in hypertensive patients.
OBJECTIVES: The purpose of this study was to evaluate the feasibility of assessing blood flow in the coronary sinus by transthoracic Doppler echocardiography for detecting coronary artery stenosis in hypertensive patients. METHODS: Flow in the coronary sinus was studied in 105 participants who all had undergone coronary angiography: 35 nonhypertensive patients, 34 hypertensive patients without coronary artery disease (CAD), and 36 hypertensive patients with CAD. The antegrade phase of flow in the coronary sinus was analyzed and compared among the groups. Multivariate analysis for blood flow and coronary artery stenosis was done. RESULTS: Compared with the nonhypertensive patients, the hypertensive patients without CAD had significantly higher blood flow (9.36 ± 5.94 vs 5.84 ± 2.91 mL/stroke and 584.45 ± 177.32 vs 327.68 ± 125.48 mL/min, respectively; P < .001) in the coronary sinus. Compared with the hypertensive patients without CAD, those with CAD had significantly lower blood flow (5.18 ± 0.72 vs 9.36 ± 5.94 mL/stroke and 352.51 ± 156.18 vs 584.45 ± 177.32 mL/min; P < .001) and a lower velocity time integral (13.14 ± 2.51 vs 19.85 ± 4.89 cm; P < .01). Stepwise multiple regression analysis indicated that the coronary sinus diameter, velocity time integral, and heart rate significantly correlated with the blood flow per minute in the coronary sinus in each group, and the flow per minute was the independent determinant of the percent stenosis diameter. The sensitivity, specificity, and accuracy for the prediction of severe stenosis (>70%) in the left coronary artery were 91.07%, 87.76%, and 88.49% for blood flow of less than 220 mL/min in the coronary sinus. CONCLUSIONS: Transthoracic Doppler echocardiography can effectively depict blood flow changes in the coronary sinus, and reduced antegrade flow is a sensitive and specific predictor of coronary artery stenosis in hypertensive patients.
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Zheng et al. (2012) conducted a cross-sectional in Hypertension and coronary artery stenosis (n=105). Blood flow in the coronary sinus assessed by transthoracic Doppler echocardiography vs. Hypertensive patients without CAD was evaluated on Blood flow in the coronary sinus (mL/min) (p=<.001). Reduced antegrade coronary sinus blood flow (<220 mL/min) assessed by echocardiography predicted severe left coronary artery stenosis with 91.07% sensitivity and 87.76% specificity.
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