心エコー図法による冠血流予備能測定の意義

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タイトル別名
  • Usefulness of Coronary Flow Reserve Measurements by Echocardiography
  • ミニレビュー 心エコー図法による冠血流予備能測定の意義
  • ミニレビュー シン エコー ズホウ ニ ヨル カン ケツリュウ ヨビノウ ソクテイ ノ イギ

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Fundamental mechanism of myocardial ischemia is myocardial perfusion abnormality. Coronary flow reserve (CFR) has been recognized as a physiological index of the capacity to increase coronary blood flow in response to increased oxygen demand. Therefore, reduced CFR directly reflects impairment of myocardial perfusion. Clinically, positron emission tomography and Doopler guidewire by cardiac catheterization are the common methods to evaluate CFR. However, these methods are relatively expensive or invasive. Recent advance in transthoracic echocardiography has enabled us to measure CFR, especially in the left anterior descending coronary artery territory. This method has been validated by Doppler guidewire and myocardial scintigraphy, and now can be applied for the evaluation of the impairment of coronary microcirculation. CFR measurements by echocardiography is totally noninvasive, reproducible and cost effective, thus would be useful for the assessment of physiological severity of coronary artery stenosis and coronary microcirculatory disorders.

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