COMPARISON OF INTRACORONARY DOPPLER GUIDE-WIRE AND TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN MEASUREMENT OF FLOW VELOCITY AND CORONARY FLOW RESERVE IN THE LEFT ANTERIOR DESCENDING CORONARY-ARTERY

Background The intracoronary Doppler tipped guide wire has been shown to be highly accurate in the measurement of coronary flow velocity (CF V). Recent studies have indicated that blood flow velocity in the left anterior descending coronary artery (LAD) con be determined by transe sophageal echocardiography (TEE). The purpose of this study was to com pare Row velocity recordings and coronary Flow reserve measurements in the IAD by TEE with those obtained by Doppler guide wire. Methods and Results The study population consisted of 14 patients with chest pain and normal coronary arteriograms. After routine coronary arteriograph y was performed, a 0.014-inch Doppler guide wire was advanced into the proximal part of the LAD. After baseline measurement of coronary flow velocity (CFV) was obtained, 140 mu g/kg/min adenosine was administer ed intravenously for 3 minutes, and the flow velocity was recorded. TE E was performed within 24 hours of the cardiac catheterization. After baseline measurements of CFV in the IAD, heart rate, and blood pressur e were obtained, 140 mu g/kg/min adenosine was administered intravenou sly, and the CFV was recorded. Coronary flow reserve was calculated as the ratio of the peak diastolic CFV during adenosine infusion to the peak diastolic CFV at baseline. A good correlation was found (r = 0.91 , p < 0.0001) between CFV by Doppler guide wire and that determined by TEE. A good correlation was also found between the coronary flow rese rve assessed by Doppler guide wire and that determined by TEE (r = 0.9 2, p < 0.0001). Conclusion Our data indicate that CFV and coronary flo w reserve in the IAD can be accurately measured by transesophageal ech ocardiography.