Significance of the Distal to Proximal Coronary Flow Velocity Ratio by Transthoracic Doppler Echocardiography for Diagnosis of Proximal Left Coronary Artery Stenosis

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This study was designed to evaluate the significance of accelerated coronary flow velocity in the proximal left coronary artery by transthoracic Doppler echocardiography for detecting coronary stenosis.


Seventy subjects with suspected coronary artery disease underwent successful coronary flow velocity measurement in both proximal and distal lesions by transthoracic Doppler echocardiography and coronary angiography.


On the basis of the coronary angiography results, 23 patients had significant (≥50%) stenosis in the proximal left coronary artery (Group S) and 47 patients had no stenosis (Group N). The distal averaged diastolic peak velocity to proximal averaged diastolic peak velocity ratio (DAPAR) in Group S was significantly lower than that in Group N. A cutoff value of DAPAR ≤ 0.5 for DAPAR predicted significant coronary stenosis with a sensitivity of 91% and a specificity of 72%.


Measurement of the DAPAR by transthoracic Doppler echocardiography is a promising method in the noninvasive diagnosis of stenosis in the proximal left coronary artery lesion.

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