Vasodilation of epicardial coronary artery can be measured with transthoracic echocardiography

Transthoracic Doppler echocardiography (TTE) has been introduced as a noninvasive tool to measure coronary flow velocity reserve (CFVR). Velocity measurement, however, fails to take into account epicardial coronary artery vasodilation during hyperemia and this may cause underestimation of CFVR measurements. Therefore, we sought to determine whether the vasodilation of epicardial coronary artery can be measured during cold pressor test (CPT) and adenosine infusion simultaneously with the flow velocity measurement using TTE. We studied 41 healthy nonsmoking men with a linear high-frequency 8.0-MHz transducer. The CPT and adenosine infusion dilated the diameter of the distal left anterior descending coronary artery (LAD) from 1.4 +/- 0.4 mm to 1.5 +/- 0.4 mm (14 +/- 13%, p < 0.01) and from 1.4 +/- 0.4 mm to 1.8 +/- 0.5 mm (31 +/- 19%, p < 0.01), respectively. The CPT increased flow velocity and calculated coronary blood flow rate (velocity time integral x cross-sectional area) from 0.23 +/- 0.05 m/s to 0.36 +/- 0.13 m/s (31 +/- 34%, p < 0.01) and from 8.1 +/- 4.2 mL/min to 11.4 +/- 6.0 mL/min (47 +/- 51%, p < 0.01). CFVR and calculated coronary blood flow rate reserve were 3.9 +/- 1.0 and 6.0 +/- 1.9, respectively. In Bland-Altman analysis, velocity measurements underestimated the vasodilation response of the CPT and adenosine compared with the measurements where epicardial diameter dilation was taken into account. Intra- and interobserver variability of diameter measurements was low (coefficient of variation [CV] 2.6 to 6.5%). Day-to-day, within-day and intersonographer variabilities were of similar magnitude (CV 4.6 to 8.2%), suggesting good reproducibility. This study demonstrates that TTE can be used to assess changes in both epicardial coronary artery diameter and flow velocity simultaneously in the distal LAD artery.     

冷加压实验超声心动图及冠脉血流显像技术评价冠脉微循环内皮功能

目的应用冷加压实验超声心动图及冠脉血流显像技术评价冠状动脉造影结果正常的冠心病高危人群的微循环内皮功能。方法冠脉造影结果正常受检者40例,分为无冠心病危险因素的对照组20例和冠心病高危人群组20例。分别于静息状态下、冷加压实验后、舌下含服硝酸甘油后测量冠状动脉左主干内径并计算其内径变化率;测量冠状动脉左前降支舒张期峰值血流速度,并计算其流速变化率,比较两组干预状态下的内径变化率和流速变化率。结果静息状态下两组冠脉内径及峰值流速基础值之间均无统计学差异（P〉0．05）。冷加压实验后,冠心病高危人群组冠脉内径扩张率（4．53±2．65）％、流速增加率（23．64±5．72）％,低于对照组的（11．37±3．29）％及（43．76±4．28）％（P〈0．05）。含服硝酸甘油后,两组内径变化率和流速变化率之间无统计学差异（P〉0．05）。结论冠心病高危人群在冠脉造影结果正常时可能已合并冠状动脉微循环内皮功能损伤,冷加压实验超声心动图评价冠状动脉微循环内皮功能有一定可行性。     

Technical achievement: transthoracic Doppler echocardiography can be used to detect LAD restenosis after coronary angioplasty

We investigated the capability of transthoracic Doppler echocardiography (TTE) to detect and quantify the severity of restenosis in the left anterior descending coronary artery (LAD) after percutaneous transluminal coronary angioplasty (PTCA). We studied 10 consecutive patients assigned for quantitative coronary angiography (qCA) due to a recurrent angina pectoris after PTCA of the LAD. The LAD was visualized by TTE, and the presence of local turbulence and an increase in the blood flow velocity was regarded to indicate coronary stenosis. To assess the severity of the stenosis, the increase of blood flow velocity was measured. Angiography showed stenoses of various degrees (27–100%) in all patients. All stenoses were detectable using TTE. Moreover, the ratio of maximal blood flow velocity at the site of stenosis to the pre‐stenotic blood flow velocity (M/P‐ratio) correlated significantly with the reduction of the luminal diameter of LAD (r=0·85, P<0·003). A M/P‐ratio higher than 3·0 predicted a diameter reduction of 50% or higher with sensitivity and specificity of 100% in patients with a subtotal stenosis (n=9). Our results indicate that stenoses in the LAD could be found and the severity of the stenoses could be quantified reliably with TTE. This approach is totally non‐invasive and less expensive than coronary angiography and can be used clinically in clarifying restenosis after coronary angioplasty.     

Coronary flow reserve: measurement with transthoracic Doppler echocardiography is reproducible and comparable with positron emission tomography

Detection of early vascular changes indicated by lowered coronary flow reserve (CFR) would allow early treatment and prevention of atherosclerosis. The purpose of this study was to test whether it is possible to reproducibly measure CFR with transthoracic Doppler echocardiography (TTE) in healthy volunteers. We measured CFR using dipyridamole infusion in ten healthy male volunteers with two methods: TTE and positron emission tomography (PET) with oxygen‐15‐labelled water (group A). However, CFR was assessed twice with TTE in eight healthy male volunteers (group B) to study the reproducibility of this method. We compared CFRs obtained using TTE flow measurements in the left anterior descending coronary artery (LAD) and PET flow measurements in the corresponding myocardial area. Coronary flow in LAD could be measured in all subjects using TTE. By TTE, an average CFR based on peak diastolic flow velocity (PDV) was 2·72 ± 1·16, mean diastolic flow velocity (MDV) 2·56 ± 1·06 and velocity time integral (VTI) 1·87 ± 0·49. The results were reproducible in two repeated TTE studies (coefficient of variation in MDV 6·1 ± 4·3%, n=8). By PET, CFR was 2·52 ± 0·84. CFR assessed by TTE correlated closely with that measured by PET (MDV r=0·942, P<0·001; PDV r=0·912, P<0·002 and VTI r=0·888, P<0·006) and intraclass correlation was 0·929 (MDV) and tolerance limits for differences of CFRs was ?0·78 to 0·72. We show that CFR measured by TTE has an excellent correlation with CFR measured by PET. We also found that TTE measurements of CFR were highly reproducible.     

Gender differences in response to cold pressor test assessed with velocity-encoded cardiovascular magnetic resonance of the coronary sinus

Background

Gender-specific differences in cardiovascular risk are well known, and current evidence supports an existing role of endothelium in these differences. The purpose of this study was to assess non invasively coronary endothelial function in male and female young volunteers by myocardial blood flow (MBF) measurement using coronary sinus (CS) flow quantification by velocity encoded cine cardiovascular magnetic resonance (CMR) at rest and during cold pressor test (CPT).

Methods

Twenty-four healthy volunteers (12 men, 12 women) underwent CMR in a 3 Tesla MR imager. Coronary sinus flow was measured at rest and during CPT using non breath-hold velocity encoded phase contrast cine-CMR. Myocardial function and morphology were acquired using a cine steady-state free precession sequence.

Results

At baseline, mean MBF was 0.63 ± 0.23 mL·g^-1·min^-1 in men and 0.79 ± 0.21 mL·g^-1·min^-1 in women. During CPT, the rate pressure product in men significantly increased by 49 ± 36% (p < 0.0001) and in women by 52 ± 22% (p < 0.0001). MBF increased significantly in both men and women by 0.22 ± 0.19 mL·g^-1·min^-1 (p = 0.0022) and by 0.73 ± 0.43 mL·g^-1·min^-1 (p = 0.0001), respectively. The increase in MBF was significantly higher in women than in men (p = 0.0012).

Conclusion

CMR coronary sinus flow quantification for measuring myocardial blood flow revealed a higher response of MBF to CPT in women than in men. This finding may reflect gender differences in endothelial-dependent vasodilatation in these young subjects. This non invasive rest/stress protocol may become helpful to study endothelial function in normal physiology and in physiopathology.     

经胸超声心动图评价系统性红斑狼疮患者冠状动脉血流储备

目的 研究经胸超声心动图评价系统性红斑狼疮(SLE)患者冠状动脉(冠脉)血流储备的价值.方法对24例SLE患者(SLE组)和18例健康志愿者(对照组)行经胸超卢心动图检查,获得冠状窦的内径和血流频谱,计算血流量,静脉注射潘生丁诱导冠脉扩张充血.冠状窦充血状态与基础状态血流量的比值即为冠脉血流储备.比较SLE组与对照组冠脉血流储备的差异.结果经胸超声心动图可测得两组受检者冠状宴血流量.SLE组冠脉血流储备为1.55±0.21.对照组冠脉血流储备为2.51±0.33,SLE组低于对照组,差异有统计学意义(P＜0.01).结论经胸超声心动图可用于评价SLE患者冠脉血流储备,冠脉血流储备受损提示SLE患者可能存在亚临床型冠脉疾病.     

经胸超声心动图冠状动脉血流成像技术评价阻塞性睡眠呼吸暂停综合征患者冠状动脉血流储备的价值

目的探讨经胸超声心动图冠状动脉血流成像技术评估阻塞性睡眠呼吸暂停综合征（OSA）患者冠状动脉血流储备（CFR）的价值。 方法选择2010年3月至2013年12月航天七三一医院收治的OSA患者50例。其中5≤呼吸暂停低通气指数（AHI）<20,18例;20≤AHI<40,16例;AHI≥40,16例。采用经胸超声心动图冠状动脉血流成像技术检测静息状态下冠状动脉左前降支远端舒张期最大峰值血流速度（PDV)、舒张期平均血流速度（MDV）及注射三磷酸腺苷（ATP）后PDV、MDV及CFR。选择40名健康体检者作为健康对照组。采用t检验比较OSA患者与健康对照组PDV、MDV、CFR差异;采用单因素方差分析比较不同AHI的OSA患者PDV、MDV、CFR差异,进一步组间两两比较采用SNK-q检验;采用t检验比较OSA患者、健康对照组、不同AHI的OSA患者静息状态下与ATP负荷状态下PDV、MDV差异。 结果静息状态下,全部受检者均获得满意的冠状动脉左前降支远端血流及多普勒频谱。静脉注射ATP后,健康对照组PDV、MDV分别为（92.78 ± 7.68）、（85.93 ± 6.98）cm/s,高于静息状态下的（28.09 ± 4.55）、（21.76 ± 5.09）cm/s,且差异均有统计学意义（t值分别为49.687、58.259,均P<0.001）;静脉注射ATP后,OSA患者PDV、MDV分别为（82.73 ± 6.91）、（77.39 ± 6.73）cm/s,高于静息状态下的（29.93 ± 3.66）、（22.28 ± 4.15）cm/s,且差异均有统计学意义（t值分别为55.381、47.700,均P<0.001）。静息状态下,OSA患者与健康对照组PDV、MDV差异均无统计学意义;静脉注射ATP后,OSA患者PDV、MDV均高于健康对照组,且差异均有统计学意义（t值分别为6.524、5.884,均P<0.01）。静息状态下,不同AHI的OSA患者PDV、MDV差异均无统计学意义;静脉注射ATP后,不同AHI的OSA患者PDV、MDV均较静息状态下增加,且差异均有统计学意义（5≤AHI<20：t值分别为-32.903、-32.771,均P=0.000;20≤AHI<40：t值分别为-37.122、-32.623,均P=0.000;AHI≥40：t值分别为-28.197、-20.184,均P=0.000）;且AHI≥40的OSA患者PDV、MDV均小于5≤AHI<20、20≤AHI<40的OSA患者,且差异均有统计学意义（PDV：q值分别为21.048、15.667,均P<0.05;MDV：q值分别为12.958、18.182,均P<0.05）,但5≤AHI<20的OSA患者与20≤AHI<40的OSA患者PDV、MDV差异均无统计学意义。OSA患者CFRmax、CFRmean均较健康对照组降低,且差异均有统计学意义（t值分别为5.310、6.430,均P=0.000）。不同AHI的OSA患者CFRmax、CFRmean差异均有统计学意义,而且随着疾病程度加重呈递减趋势;且5≤AHI<20的OSA患者CFRmax、CFRmean均大于20≤AHI<40、AHI≥40的OSA患者,且差异均有统计学意义（CFRmax：q值分别为2.889、4.142,均P<0.05;CFRmean：q值分别为3.080、4.204,均P<0.05）,但20≤AHI<40的OSA患者与AHI≥40的OSA患者CFRmax、CFRmean差异均无统计学意义。 结论经胸超声心动图冠状动脉血流成像技术结合ATP能够无创性评价OSA患者CRF的变化,能较为敏感地检测到冠状动脉早期病变及冠状动脉微循环功能异常,可用于患者的长期追踪随访以及药物或手术疗效的判断,具有较高的临床实用价值。     

冠状动脉血流储备的经胸多普勒超声心动图与冠状动脉内多普勒血流测量的对照研究

目的　①探讨经胸声学造影二次谐波多普勒超声心动图 (TTDE)探测冠状动脉左前降支(LAD)远端血流的可行性 ;②与冠状动脉内多普勒 (ICD)相对照 ,分析研究LAD冠状动脉血流储备(CFR)。方法　利用TTDE连续检测 110例患者LAD血流。冠状动脉血流速度储备 (CFVR)为注射腺苷后的最大平均血流速度与静息状态平均血流速度的比值。结果　CFVR探测的成功率为 96%。TTDE所探测的CFVR(2 .83± 0 .68)与ICD所探测的结果 (2 .91± 0 .74)密切相关 (r =0 .83 ,Y =0 .76X + 0 .61,P <0 .0 0 1)。结论　TTDE结合声学造影及二次谐波技术是一项可行、可信的无创性探测CFVR的方法 ,可用于冠状动脉病变的探测及冠脉介入治疗的随访。     

Adenosine induces dilation of epicardial coronary arteries in mice: relationship between coronary flow velocity reserve and coronary flow reserve in vivo using transthoracic echocardiography

For an accurate estimate of volumetric coronary flow reserve (CFR) using Doppler-assessed flow velocity measurement, it is important to take into consideration potential diameter change during coronary hyperemia. Using ultrasound techniques, left coronary artery (LCA) flow velocity and LCA lumen diameter (LCA(D)) were measured simultaneously for the first time to measure coronary flow during baseline and adenosine-induced hyperemic condition in isoflurane-anesthetized C57BL/6 (n = 38) and in old apolipoprotein E-gene deficient (ApoE(-/-)) mice (n = 44) mice. LCA(D) increased significantly and to a similar extent during adenosine infusion in both groups (3.7 +/- 1.1 %, p < 0.003 for C57BL/6; 4.2 +/- 0.9 %, p < 0.00003 for ApoE(-/-)). Yet, a positive correlation was still found between velocity-based coronary flow velocity reserve (CFVR) and volumetric CFR in both strains (R(2) = 0.77, p < 0.001 for C57BL/6; R(2) = 0.80, p < 0.001 for ApoE(-/-)). Coronary reserve was higher in C57BL/6 mice than in ApoE(-/-) mice (CFR 1.93 +/- 0.17 vs. 1.47 +/- 0.07, p < 0.05; CFVR 1.73 +/- 0.13 vs. 1.28 +/- 0.07, p < 0.01). Thus, ultrasound techniques can be used to measure volumetric flow in the LCA and flow-based CFR measurements of intact, living mice. The positive correlation between CFR and CFVR, together with the lower method variability of the latter, makes CFVR a more robust protocol for assessing mouse in-vivo coronary artery function. Therefore, the CFVR protocol will probably work well in most settings.     

Doppler echocardiographic approach to the blood flow of the left anterior descending coronary artery

Assessment of flow in the left anterior descending coronary artery by Doppler echocardiography appeared to be possible in some patients in which the coronary artery system might be wide and/or the displacement of the coronary artery might be reduced because of cardiac enlargement or of impaired cardiac function. A study of this possibility was carried out in 78 patients, 20 cases with hypertrophic cardiomyopathy, 10 with dilated cardiomyopathy, 20 with aortic valve disease, and 28 following valve replacement for aortic valve disease. The anterior interventricular sulcus was a helpful landmark to search for the left anterior descending artery. The characteristic feature of the coronary flow pattern, that the flow ran mainly during diastole, was also helpful in finding the coronary artery. Complementary roles of ultrasonic imaging and Doppler ultrasound evaluation should be emphasized for identifying a thin echo-free space in the sulcus as the coronary artery. The left anterior descending coronary artery was imaged in 26 of the 78 patients. The peak velocity ranged 24 cm/s to 75 cm/s in different patients. Because the present study was carried out in patients with some particular diseases, these results do not indicate that current techniques can be routinely used for assessing the coronary flow. The detection rate will be increased with improvements in image resolution and the Doppler sensitivity. Although the detection rate of the coronary artery was not satisfactory in the present stage, the effect of sublingual administration of nitroglycerin on coronary circulation was noninvasively assessed in some patients, where reduction of the flow velocity by about 27% was observed in real time.     

经胸壁多普勒超声心动图对冠状动脉血流的检测——与冠状动脉造影对照研究

目的探讨经胸壁多普勒超声心动图(TTDE)对冠状动脉远端血流检测的可行性.方法采用TTDE探查51例冠心病患者冠状动脉左前降支(LAD)远端及右冠状动脉后降支(PDA)血流,并与冠状动脉造影比较.结果 LAD的检出率为94%,PDA的检出率为75%,PDA未检出组的心率明显快于检出组.彩色多普勒冠脉显像为心底部朝向心尖部的舒张期持续的线状血流信号,脉冲多普勒显示以舒张期为主的双期血流频谱,有3例冠脉完全闭塞的患者检出舒张期负向血流.结论 TTDE可以较好地评价冠状动脉左前降支和右冠状动脉后降支血流,为临床提供一个无创的检查冠状动脉血流的新方法.     

A short period of apnoea causes a marked increase in coronary flow velocity: a transthoracic pulsed wave Doppler study

Coronary artery flow velocity during a short period of apnoea was investigated by transthoracic Doppler recording in 10 healthy men, aged 24-52. During breath holding for 29 +/- 6 s the oxygen saturation in the finger, measured by pulse oxymetry, decreased from 97.5 +/- 0.8 to 90.0 +/- 3.2% (P < 0.001). The maximal coronary blood flow velocity in the left anterior descending artery increased by 62% from 0.26 +/- 0.09 to 0.42 +/- 0.10 m s(-1) and the mean diastolic flow velocity by 47% from 0.19 +/- 0.04 to 0.28 +/- 0.08 m s(-1) (P < 0.001). In most subjects the increase of velocity started already after a few seconds of apnoea. Besides theoretical implications the results show that it is very important to be aware of the higher velocity during apnoea in order to avoid misinterpretation when using breath holding during magnetic resonance imaging or Doppler recording of coronary flow.     

冠状动脉微循环功能的定量评估技术及进展

冠状动脉微循环功能异常在某些情况下可导致或促成心肌缺血，广泛存在于各种心血管危险因素和疾病中，常与患者不良结局有关。目前临床上缺乏冠状动脉微血管疾病的标准化定义和特异性诊断方法，导致只能对其进行经验性治疗。本综述重点介绍用于评估冠状动脉微循环功能的相关指标、主要技术及进展，以期对冠状动脉微血管疾病的预防和诊疗提供参考。     

经胸多普勒超声无创检测冠心病患者冠状动脉各主要分支血流储备

目的 评价经胸多普勒超声心动图(TTDE)检测冠状动脉各主要分支血流储备的可行性和准确性.方法 临床疑诊冠心病拟行冠状动脉造影的439例患者,在进行冠状动脉造影前1周内进行TTDE检查,检测左前降支(LAD)、左旋支(LCx)和右冠状动脉后降支(PDA)远端的血流储备.在基础状态和持续静脉注射腺苷(140μg·kg-1·min-1)情况下分别测定其血流速度,计算血流储备(CFR)及其诊断冠状动脉狭窄的准确性.结果 439例患者中28支LAD、12支LCx和21支PDA闭塞.LAD的CFR检测成功率为96.8%(395/411),LCx的CFR检测成功率为74.9%(320/427),PDA的CFR检测成功率为83.0%(347/418).以CFR≤2.0和CFR≤1.7分别作为判断冠状动脉狭窄(≥50%)和显著狭窄(≥75%)的标准,诊断LAD、LCx和PDA狭窄的灵敏度和特异度分别为81%和87%,64%和82%,79%和85%,诊断显著狭窄的灵敏度、特异度分别为86%和81%,70%和85%,81%和82%.结论 经胸多普勒超声心动图检测冠状动脉各主要分支血流储备的成功率和判断冠状动脉狭窄的准确性均较高,具有一定临床应用价值.     

心肌桥冠状动脉血流显像与冠状动脉内多普勒检测对照分析

目的 与冠状动脉内多普勒(ICD)对照,分析冠状动脉血流显像(CFI)测最前降支心肌桥冠状动脉血流频谱特征和血流速度储备(CFVR)变化.方法 冠状动脉造影、冠状动脉血管内超声和ICD检查确诊为冠状动脉左前降支心肌桥且无明显狭窄患者9例(心肌桥组)和健康者9例(对照组),利用CFI检测基础状态和经静脉注射腺苷140μg·kg-1·min-1达到最大充血反应状态时冠状动脉左前降支血流,分别通过舒张期最大峰值血流速度(PDV)、舒张期平均血流速度(MDV)和平均峰值血流速度(APV)计算冠状动脉血流速度储备.与ICD测值相比较,分析CFI方法的准确性.结果 CFI测量心肌桥组和对照组冠状动脉前降支中远端血流,心肌桥组中6例CFI频谱表现为"拇指征",其测值与ICD测值的回归方程分别为y1=0.54x 1.22、y2=0.55x 1.08和y=0.87x 0.39,相关系数r分别为0.65、0.70和0.81(P＜0.01).与对照组比较,冠状动脉血流速度参数中年龄和基础状态的差异无统计学意义;心肌桥组最大充血反应状态冠状动脉血流速度参数明显低于对照组,CFVR亦明显低于对照组,均有统计学差异.结论 CFI是一项准确测量CFVR的方法,通过舒张期平均血流速度计算CFVR,测值准确且简便,可广泛用于临床;CFVR的减低,可能是导致心肌桥患者心绞痛的原因之一.     

无创性冠状动脉血流显像检测冠状动脉血流储备在冠状动脉造影正常患者中的临床应用研究

目的本研究旨在通过冠状动脉血流显像(CFI)结合腺苷负荷试验,无创性检测有胸闷、胸痛等临床症状但冠状动脉造影正常患者的冠状动脉血流储备功能,探讨冠状动脉血流显像无创性检测冠状动脉血流储备的可行性,以及这组病人的冠状动脉血流储备功能变化。方法选择冠状动脉造影正常者34例,其中高血压和/或高脂血症患者19例,设为病例组;另15例为正常对照组。采用冠状动脉血流显像测量基础及最大充血反应状态下冠状动脉左前降支远段的血流速度,计算冠状动脉血流速度储备(CFVR,冠状动脉最大充血反应状态与基础状态下的平均舒张期血流速度之比),分析比较病例组与正常对照组冠状动脉血流测值。结果34例患者均成功测量了CFVR。病例组左前降支CFVR明显低于正常对照组(2.86±0.40 vs 3.30±0.28,P<0.05),基础状态和最大充血反应状态时冠状动脉血流参数两组间的差异无统计学意义。结论冠状动脉血流显像结合腺苷负荷试验是一项安全、可行测量CFVR的方法;冠状动脉造影正常,但伴有胸闷、胸痛等临床症状的患者,存在冠状动脉血流储备功能的减低;高血压和高血脂症是导致CFVR减低的原因之一。     

经胸超声冠状动脉血流显像技术评价支架术前后冠状动脉血流储备的初步临床应用

目的　探讨经胸超声冠状动脉血流显像技术评估冠心病支架术前、后冠状动脉血流储备(CFR)的价值。方法　 2 8例冠状动脉前降支狭窄的冠心病患者对狭窄的冠状动脉行经皮冠状动脉内成形术 (PTCA)后各置入 1枚支架。分别于术前、术后 72h内 ,采用经胸超声多普勒冠状动脉血流显像技术检测左冠状动脉前降支狭窄远端静息舒张期血流峰速 (r Vd)、注射潘生丁时最大舒张期血流峰速 (d Vd)及CFR。结果　 2 8例患者行支架术均获成功 ,狭窄率由术前 84.2 %± 8.6%降至术后 5 .4%± 0 .8% ,(P <0 .0 5 ) 。 2 8例患者共 40支病变血管中 ,3 4支狭窄冠状动脉远端检测到多普勒频谱 (检出率 85 % )。支架术后r Vd较术前r Vd有增加趋势 ,但差异无显著性意义 ( P >0 .0 5 ) ;术后静脉注射潘生丁后最大d Vd及CFR均较术前明显增加 [( 0 .94± 0 .2 1)m/s对 ( 0 .5 1± 0 .18)m /s ,3 .2 1± 1.2 1对 1.89± 0 .40 ,均P <0 .0 5 ]。结论经胸超声多普勒冠状动脉血流显像技术结合潘生丁试验是一种简便、易行、无创性评价冠心病患者冠状动脉介入治疗前后血流储备变化的新方法。