Objective
TITLE: Coronary flow reserve estimated by transoesophageal dipyridamole stress Doppler in the evaluation of coronary artery disease. Comparison with dipyridamole stress echocardiography. The impact of coronary angioplasty.
Transoesophageal dipyridamole stress Doppler allows estimation of coronary artery blood flow dynamics noninvasively at relatively low cost. Assessment of coronary flow reserve enables determination of hemodynamic significance of coronary stenosis.
The aim of the study is: 1) to assess the significance of coronary artery flow reserve measured noninvasively by means of transoesophageal dipyridamole stress Doppler in evaluation of CAD and to compare results of this method with dipyridamole stress echocardiography, 2) to establish the clinical value of the above techniques in determining the indications to coronary angiography and invasive treatment in CAD, 3) to evaluate the influence of PTCA on coronary artery flow reserve and myocardial function, and 4) to detect reocclusion after PTCA on the ground of these noninvasive methods.
40 patients with angina pectoris and/or previous myocardial infarction and significant CAD confirmed by coronary angiography will be included (group A). The subgroup of 20 patients undergoing PTCA (group A1) will be classified as well.
Exercise ecg, rest transthoracic echocardiography, dipyridamole stress echocardiography and transoesophageal dipyridamole stress Doppler will be performed in all patients two times at 3 months interval. In patients undergoing PTCA we foresee 3 examinations: before and 7 days and 3 months after the procedure. Coronary angiography will be repeated in the event of clinical worsening (unstable, particularly rest intractable angina pectoris) and/or suspicion of coronary reocclusion on the ground of transoesophageal dipyridamole stress Doppler.
We expect that: 1) transoesophageal dipyridamole stress Doppler and dipyridamole stress echocardiography will be useful in determining the indications to coronary angiography and invasive treatement of CAD, 2)transoesophageal dipyridamole stress Doppler performed after PTCA may limit the need for invasive assessment of coronary antery tree.
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Coordinator
56126 Pisa
Italy
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