Zusammenfassung
Mittels hochauflösender transthorakaler Echokardiographie ist die Darstellung
der mittleren und distalen RIVA-Abschnitte und des Mammaria-Bypasses mit nachfolgender
Bestimmung der CFR in über 90 % der Fälle möglich. Die Bestimmung der CFR gelingt
in der rechten Koronararterie in über 80 % der Fälle. Das Verfahren ist nicht-invasiv,
für den Patienten nur gering belastend und kann wiederholt durchgeführt werden.
Die echokardiographische Erfassung der CFR stellt eine Bereicherung in der nicht-invasiven
Diagnostik von kardialen Makro- als auch Mikrozirkulationsstörungen dar. Zusammen
mit dem koronarmorphologischem Befund ist das Verfahren hilfreich bei der Planung
von Koronarinterventionen des RIVA und der RCA, in der Verlaufsbeurteilung kann
es zur Restenoseerkennung eingesetzt werden. Nach Anlage eines Mammaria-Bypasses
ermöglicht die CFR-Messung im Bypass oder distal der Bypass-Anastomose die Funktionsbeurteilung.
Mikrozirkulationsstörungen können bei ausgeschlossener koronarer Herzerkrankung
mittels CFR-Bestimmung erkannt und unter Therapie im Verlauf beobachtet werden.
Abstract
Coronary flow reserve can be determined echocardiographically in the LAD in about
90 % and in the RCA in more than 80 % of patients respectively by the use of modern
high-resolution ultrasound equipment. For this purpose either high frequency fundamental
imaging or echo-contrast enhanced harmonic Doppler technology is used. The main
advantage of the method lies in its noninvasiveness and the lack of radiation
exposure. In combination with coronary morphologic findings obtained from heart
catheterization, CFR is helpful in the planning of further invasive procedures
for coronary artery disease and in the estimation of the prognosis of such
procedures. The functional status after PTCA of LAD/RCA or mammary bypass surgery
can be evaluated during follow-up monitoring. Alteration in the coronary microcirculation
can also be discovered in a non-invasive way, improvement of microcirculatory
disorders by adequate therapy can be assessed by serial measurements of CFR
Schlüsselwörter
Koronare Flussreserve - Doppler-Echokardiographie - Koronarperfusion
Key words
Coronary flow reserve - cardiac ultrasound - coronary perfusion
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Prof. Dr. Dr. med. H. Lambertz
Abteilung für Kardiologie · Deutsche Klinik für Diagnostik
Aukammallee 33 · 65191 Wiesbaden ·
Phone: 0611-577224
Fax: 0611-577325
Email: lambertz.kardio@dkd-wiesbaden.de