Skip to main content
Download PDF

Feasibility of 3D4D echocardiography for the detection of colour-coded flow in the left anterior descending artery

Echo Research & Practice volume 1, pages 23–30 (2014)Cite this article

Abstract

The aim of this study was to test the feasibility of the visualisation of 3D4D coronary flow in detectable segments of coronary arteries. Regarding the feasibility of this new approach, the hypothesis was proposed that the flow signals of the course of detectable coronary arteries can be better visualised by 3D4D echocardiography than by the conventional 2D approach. A total of 30 consecutive patients with sinus rhythm, in whom the distal left anterior descending artery (LAD) was visualised by 2D colour-coded Doppler echocardiography, were selected for 3D4D scanning procedures. All measurements were performed using a Vivid 7 or E9. All segments visualised by 2D colour-coded Doppler echocardiography were also examined by 3D4D echocardiography. Using defined settings, the width of the colour-coded flow signal differs significantly between 2D- and 3D4D echocardiography. The length of larger segments of the visualised colour-coded flow signal of the coronary flow could be better detected with 2D imaging. Small segments of coronary artery flow (<11-mm), however, could be significantly better visualised by 3D4D echocardiography. The main advantage of 3D4D echocardiography of the coronary artery flow is the visualisation of the proportions of vessels with complex morphology. 3D4D echocardiography of LAD flow by colour-coded Doppler echocardiography raises new possibilities for the direct flow visualisation of the detectable segments of coronaries. With its sufficiently high spatial and temporal resolution, this new method has the potential to be implemented in clinical scenarios. The possible application to the quantification of stenoses by the flow visualisation has to be evaluated in further studies.

References

  1. Chammas E, Dib C, Rahhal M, Helou T, Ghanem G & Tarcha W 2007 Noninvasive assessment of coronary flow reserve in the left anterior descending artery by transthoracic echocardiography before and after stenting. Echocardiography 24 789–794. doi:10.1111/j.1540-8175.2007.00478.x

    Article  Google Scholar 

  2. Pizzuto F, Voci P, Mariano E, Puddu PE, Sardella G & Nigri A 2001 Assessment of flow velocity reserve by transthoracic Doppler echocardiography and venous adenosine infusion before and after left anterior descending coronary artery stenting. Journal of the American College of Cardiology 38 155–162. doi:10.1016/S0735-1097(01)01333-X

    Article  CAS  Google Scholar 

  3. Pizzuto F, Voci P, Mariano E, Puddu PE, Chiavari PA & Romeo F 2003 Noninvasive coronary flow reserve assessed by transthoracic coronary Doppler ultrasound in patients with left anterior descending coronary artery stents. American Journal of Cardiology 91 522–526. doi:10.1016/S0002-9149(02)03298-8

    Article  Google Scholar 

  4. Dimitrow PP & Krzanowski M 2005 Coronary flow reserve assessment. European Heart Journal 26 849 doi:10.1093/eurheartj/ehi211

    Article  Google Scholar 

  5. Lambertz H, Tries HP, Stein T & Lethen H 1999 Noninvasive assessment of coronary flow reserve with transthoracic signal-enhanced Doppler echocardiography. Journal of the American Society of Echocardiography 12 186–195. doi:10.1016/S0894-7317(99)70134-3

    Article  CAS  Google Scholar 

  6. Iwata S, Hozumi T, Matsumura Y, Sugioka K, Yoshitani H, Murata E, Takemoto Y, Kobayashi Y, Yoshiyama M & Yoshikawa J 2006 Cut-off value of coronary flow velocity reserve by transthoracic Doppler echocardiography for the assessment of significant donor left anterior descending artery stenosis in patients with spontaneously visible collaterals. American Journal of Cardiology 98 298–302. doi:10.1016/j.amjcard.2006.01.100

    Article  Google Scholar 

  7. Ikonomidis I, Tzortzis S, Paraskevaidis I, Triantafyllidi H, Papadopoulos C, Papadakis I, Trivilou P, Parissis J, Anastasiou-Nana M & Lekakis J 2012 Association of abnormal coronary microcirculatory function with impaired response of longitudinal left ventricular function during adenosine stress echocardiography in untreated hypertensive patients. European Heart Journal Cardiovascular Imaging 13 1030–1040. doi:10.1093/ehjci/jes071

    Article  Google Scholar 

  8. Hyodo E, Hirata K, Hirose M, Sakanoue Y, Nishida Y, Arai K, Kawarabayashi T, Shimada K, Hozumi T, Muro T et al 2012 Detection of restenosis after percutaneous coronary intervention in three major coronary arteries by transthoracic Doppler echocardiography. Journal of the American Society of Echocardiography 23 553–559. doi:10.1016/j.echo.2010.03.007

    Article  Google Scholar 

  9. Meimoun P, Boulanger J, Luycx-Bore A, Zemir H, Elmkies F, Malaquin D, Doutrelan L & Tribouilloy C 2010 Non-invasive coronary flow reserve after successful primary angioplasty for acute anterior myocardial infarction is an independent predictor of left ventricular adverse remodelling. European Journal of Echocardiography 11 711–718. doi:10.1093/ejechocard/jeq049

    Article  Google Scholar 

  10. D’Andrea A, Severino S, Mita C, Riegler L, Cocchia R, Gravino R, Castaldo F, Scarafile R, Salerno G, Pirone S et al 2009 Clinical outcome in patients with intermediate stenosis of left anterior descending coronary artery after deferral of revascularization on the basis of noninvasive coronary flow reserve measurement. Echocardiography 26 431–440. doi:10.1111/j.1540-8175.2008.00807.x

    Article  Google Scholar 

  11. Voci P & Pizzuto F 2001 Imaging of the posterior descending coronary artery. The last frontier in echocardiography. Italian Heart Journal 2 418–422.

    CAS  PubMed  Google Scholar 

  12. Lethen H, Tries HP, Kersting S & Lambertz H 2003 Validation of noninvasive assessment of coronary flow velocity reserve in the right coronary artery. A comparison of transthoracic echocardiographic results with intracoronary Doppler flow wire measurements. European Heart Journal 24 1567–1575. doi:10.1016/S0195-668X(03)00284-7

    Article  Google Scholar 

  13. Cortigiani L, Rigo F, Sivari R, Gherardi S, Bovenzi F & Picano E 2009 Prognostic correlates of combined coronary flow reserve assessment on left anterior descending and right coronary artery in patients with negative stress echocardiography by wall motion criteria. Heart 95 1423–1428. doi:10.1136/hrt.2009.166439

    Article  CAS  Google Scholar 

  14. Auriti A, Pristipino C, Cianfrocca C, Granatelli A, Guido V, Pelliccia F, Greco S, Richichi G & Santini M 2007 Distal left circumflex coronary artery flow reserve recorded by transthoracic Doppler echocardiography: a comparison with Doppler-wire. Cardiovascular Ultrasound 5 22 doi:10.1186/1476-7120-5-22

    Article  Google Scholar 

  15. Krzanowski M, Bodzoń W & Dimitrow PP 2003 Imaging of all three coronary arteries by transthoracic echocardiography. An illustrated guide. Cardiovascular Ultrasound 1 1–16. doi:10.1186/1476-7120-1-16

    Article  Google Scholar 

  16. Murata E, Hozumi T, Matsumura Y, Fujimoto K, Sugioka K, Takemoto Y, Watanabe H, Yamagishi H, Yoshiyama M, Iwao H et al 2006 Coronary flow velocity reserve measurement in three major coronary arteries using transthoracic Doppler echocardiography. Echocardiography 23 279–286. doi:10.1111/j.1540-8175.2006.00206.x

    Article  Google Scholar 

  17. Tries HP, Lambertz H & Lethen H 2002 Transthoracic echocardiographic visualisation of coronary artery blood flow and assessment of coronary flow reserve in the right coronary artery: a first report of 3 patients. Journal of the American Society of Echocardiography 15 739–742. doi:10.1067/mje.2002.118525

    Article  Google Scholar 

  18. Cortigiani L, Rigo F, Gherardi S, Bovenzi F, Molinaro S, Picano E & Sicari R 2013 Prognostic implication of Doppler echocardiographic derived coronary flow reserve in patients with left bundle branch block. European Heart Journal 34 364–373. doi:10.1093/eurheartj/ehs310

    Article  Google Scholar 

  19. Lethen H, Tries HP, Brechtken J, Kersting S & Lambertz H 2003 Comparison of transthoracic Doppler echocardiography to intracoronary Doppler guidewire measurements for assessment of coronary flow reserve in the left anterior descending artery for detection of restenosis after coronary angioplasty. American Journal of Cardiology 91 412–417. doi:10.1016/S0002-9149(02)03235-6

    Article  Google Scholar 

  20. Ruscazio M, Montisci R, Colonna P, Caiati C, Chen L, Lai G, Cadeddu M, Pirisi R & Iliceto S 2002 Detection of coronary restenosis after coronary angioplasty by contrast-enhanced transthoracic echocardiographic Doppler assessment of coronary flow velocity reserve. Journal of the American College of Cardiology 40 896–903. doi:10.1016/S0735-1097(02)02055-7

    Article  Google Scholar 

  21. Meimoun P, Benali T, Elmkies F, Sayah S, Luycx-Bore A, Doutrelan L, Hamdane Z, Boulanger J & Tribouilloy C 2009 Prognostic value of transthoracic coronary flow reserve in medically treated patients with proximal left anterior descending artery stenosis of intermediate severity. European Journal of Echocardiography 10 127–132. doi:10.1093/ejechocard/jen190

    Article  Google Scholar 

  22. Rigo F, Gherardi S, Galderisi M, Pratali L, Cortigiani L, Sicari R & Picano E 2006 The prognostic impact of coronary flow-reserve assessed by Doppler echocardiography in non-ischaemic dilated cardiomyopathy. European Heart Journal 27 1319–1323. doi:10.1093/eurheartj/ehi795

    Article  Google Scholar 

  23. Rigo F, Sicari R, Gherardi S, Djordjevic-Dikic A, Cortigiani L & Picano E 2007 Prognostic value of coronary flow reserve in medically treated patients with left anterior descending coronary disease with stenosis 51% to 75% in diameter. American Journal of Cardiology 100 1527–1531. doi:10.1016/j.amjcard.2007.06.060

    Article  Google Scholar 

  24. Rigo F, Sicari R, Gherardi S, Djordjevic-Dikic A, Cortigiani L & Picano E 2008 The additive prognostic value of wall motion abnormalities and coronary flow reserve during dipyridamole stress echo. European Heart Journal 29 79–88. doi:10.1093/eurheartj/ehm527

    Article  Google Scholar 

  25. Ascione L, Carlomagno G, Sordelli C, Iengo R, Monda V, Severino S, Merenda R, D’Andrea A & Caso P 2013 Dipyridamole coronary flow reserve stratifies prognosis in acute coronary syndrome patients without left anterior descending disease. European Heart Journal Cardiovascular Imaging 14 858–864. doi:10.1093/ehjci/jes305

    Article  Google Scholar 

  26. Wild PS & Zotz R 2002 Fragment reconstruction of coronary arteries by transesophageal echocardiography. A method for visualizing coronary arteries with ultrasound. Circulation 105 1579–1584. doi:10.1161/01.CIR.0000012548.11483.C9

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology and Angiology, Department of Internal Medicine, Neurology and Dermatology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany

    Stephan Stoebe, Dietrich Pfeiffer & Andreas Hagendorff

Authors
  1. Stephan Stoebe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dietrich Pfeiffer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andreas Hagendorff
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stephan Stoebe.

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://doi.org/creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stoebe, S., Pfeiffer, D. & Hagendorff, A. Feasibility of 3D4D echocardiography for the detection of colour-coded flow in the left anterior descending artery. Echo Res Pract 1, 23–30 (2014). https://doi.org/10.1530/ERP-14-0024

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1530/ERP-14-0024

Keywords

Echo Research & Practice

ISSN: 2055-0464

Contact us