Usefulness of dipyridamole stress echocardiography for predicting graft patency after coronary artery bypass grafting

Chirillo, Fabio; Bruni, Andrea; Leo, Alessandro De; Olivari, Zoran; Franceschini-Grisolia, Enrico; Totis, Oscar; Stritoni, P

doi:10.1016/j.amjcard.2003.09.007

Cited by 25 publications

(7 citation statements)

References 18 publications

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“…In a meta-analysis on CFR and wall motion, a head-tohead comparison during DIPSE published by Rigo et al (Table 2), they identified five articles (from Italy, Argentina, and Japan) and found an increase in diagnostic accuracy of 79±5 to 89±7 [4•, 7••, [10][11][12][13]. It becomes clear that by adding the CFR-LAD evaluation to wall motion analysis, there is an increase in the sensitivity of the test, while maintaining a very good value in terms of specificity.…”

Section: Coronary Flow Reserve During Dipyridamole Stress Echocardiogmentioning

confidence: 99%

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Assessment of Coronary Flow During Stress Testing: Does it Add Diagnostic and Prognostic Value?

Lowenstein¹,

Tiano

2011

Curr Cardiovasc Imaging Rep

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The aim of this review is to focus on the additional diagnostic and prognostic value of Doppler echocardiographicderived coronary flow reserve over regional wall motion during pharmacological stress echocardiography in different clinical scenarios. Imaging coronary flow dramatically expands the diagnostic and prognostic potential of stress echocardiography and this is probably one of the largest contributions, considering that we are witnessing a more rational and advanced methodology of second-generation stress echocardiography.

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Section: Coronary Flow Reserve During Dipyridamole Stress Echocardiogmentioning

confidence: 99%

“…CFR and 2D echocardiography wall motion analysis offer complementary information, usually in a one shot study during pharmacological stress testing [4•, 7••, [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Coronary Flow During Stress Testing: Does it Add Diagnostic and Prognostic Value?

Lowenstein¹,

Tiano

2011

Curr Cardiovasc Imaging Rep

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“…Abstract examination and investigating the references identified 38 articles, which were retrieved in full. Eighteen papers were excluded in total for various reasons: repetition of data [9,10], insufficient data reporting [11][12][13], intraoperative TDE data [14][15][16], lack of patency assessment [17][18][19][20][21][22] and inclusion of patent grafts only [23][24][25][26]. The remaining 20 articles [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] were included for analysis after extraction of study characteristics (Table 1).…”

Section: Eligible Studiesmentioning

confidence: 99%

Does Doppler echography have a diagnostic role in patency assessment of internal thoracic artery grafts?

Jones

Athanasiou

Tekkis

et al. 2005

European Journal of Cardio-Thoracic Surgery

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The amount of literature published over the past decade comparing coronary angiography with transthoracic Doppler echocardiography assessment of internal thoracic artery graft patency after CABG is substantial. There has been no review of the available literature, and conflicting reports of diagnostic accuracy have prevented routine use of transthoracic Doppler in graft patency assessment. Thus, this article reviews the available literature on diagnostic accuracy of transthoracic Doppler echocardiography of coronary bypass grafts. Relevant studies were identified and meta-analysis of diagnostic accuracy was performed. Study quality was assessed. Quantitative data synthesis included calculation of sensitivity, specificity, summary receiver operating characteristic curve analysis, pooled analysis and meta-regression of accuracy against study quality, publication date, angina, probe frequency and diagnostic criteria. Twenty studies of 929 patients produced 26 results included for analysis. Grafts were not visualized in 93 (10%) patients. Pooled sensitivity (85%) and specificity (94%) and diagnostic odds ratio (100.7) were high. SROC analysis showed an area under the curve of 0.96. Heterogeneity of results was due to variations in diagnostic criteria and study size. Subgroup analysis showed best performance in patients with postoperative angina (p = 0.014). Study quality did not affect results. Diastolic fraction less than 0.5 (sensitivity 89%, specificity 94%) was shown to be the best criterion for prediction of stenosis. Performance was lower using peak diastolic to systolic velocity ratio less than 1 (sensitivity 85%, specificity 86%). Transthoracic Doppler echography is effective in first-line assessment of left internal thoracic artery graft patency. It shows high specificity, prevents invasive investigations and improves in patients with postoperative angina. TDE is best used in combination with other non-invasive tests due to its inability to visualize the graft. The potential for use in postoperative coronary bypass patients is high.

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“…A predominant baseline diastolic flow velocity, similar to the native coronary pattern, with a peak diastolic flow velocity (PDV) greater than peak systolic flow velocity (PSV), is typical of LIMA without stenosis [12]. On the other hand, a predominant PSV at baseline, previ- ously considered as a marker of LIMA graft dysfunction [23] may also be detected in other conditions as residual mammary artery side branches [12,15,24] and partially occluded recipient artery distal to the graft anastomosis [24,25]. Several reports have shown that a decrease in PDV/PSV <0.5 or 0.6 is a powerful predictive parameter of LIMA graft stenosis [23].…”

Section: Diastolic/ Systolic Peak Wave Velocity Ratio (Pdv/psv)mentioning

confidence: 99%

Transthoracic Doppler echocardiography of the left internal mammary artery graft

Parv¹

2013

Med Ultrason

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Assessment of the left internal mammary artery (LIMA) graft patency currently requires invasive investigation through coronary angiography. In the last years the successful application of noninvasive Doppler spectrum analysis has been reported for patency assessment of the LIMA graft after myocardial revascularization. Echocardiography is considered to be a sensitive noninvasive screening modality to diagnose critical narrowing of LIMA grafts and angiography should be reserved for cases in which Doppler echocardiography fails to visualize the LIMA or reveals an abnormal flow pattern.

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Usefulness of dipyridamole stress echocardiography for predicting graft patency after coronary artery bypass grafting

Cited by 25 publications

References 18 publications

Assessment of Coronary Flow During Stress Testing: Does it Add Diagnostic and Prognostic Value?

Assessment of Coronary Flow During Stress Testing: Does it Add Diagnostic and Prognostic Value?

Does Doppler echography have a diagnostic role in patency assessment of internal thoracic artery grafts?

Transthoracic Doppler echocardiography of the left internal mammary artery graft

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