Coronary Arterial Flow Velocity Dynamics in Children Kenji Hamaoka 1 , Kohichi Sakata 1 , Yutaka Ohmochi 1 , Fumiaki Sutoh 1 , Yumi Nakagawa 1 , Takashi Hayano 1 , Zenshiro Onouchi 1 1Division of Pediatrics, Children's Research Hospital, Kyoto Prefectural University of Medicine Keyword: Dopplerガイドワイヤー , 冠血流速動態 , 小児 , dopper guide wire , coronary flow velocity dynamics , children pp.409-414
Published Date 1995/4/15
DOI https://doi.org/10.11477/mf.1404901044
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 To assess the characteristics of coronary artery flow velocity dynamics in children, we examined the phasic coronary flow velocity patterns at rest and peak hyperemic responses to intracoronary adenosine triphosphate (ATP) using a 0.018" doppler guide wire (Flo Wire®) in 30 Kawasaki disease patients with angiographically normal coronary arteries. Coronary flow reserve (CFR) was calculated as the ratio of ATP-induced hyperemic to baseline average peak velocity (APV). Flow velocity parameters (APV & maximum peak velocity) in the right coronary artery (RCA) were lower in value than those in the left anterior descending artery (LAD) and left circumflex artery (LCX). All three vessels showed a diastolic dominant flow pattern in each segment. This flow pattern was less marked in RCA. All three vessels showed a significant increase in APV and a significant decrease in peak diastolic to-peak systolic velocity ratio (DSVR) after ATP administration. CFR was significantly lower in LCX as compared with LAD and RCA (p<0.01 : 1.93 ±0.34 in LCX vs 2.32±0.42 in LAD and 2.37±0.44 in RCA). From the view points of aging, it was revealed that APVs in three vessels at rest were mildly higher in the younger age-group than in the elder, although there was statistically no significant difference between two age-groups. CFRs in LAD and LCX were significantly lower in the younger age-group than in the elder (p<0.01 in both vessels : 2.01±0.28 in the younger vs 2.53±0.37 0.37 in the elder in LAD, and 1.61± 0.15 in the younger vs 2.06 -0.31 in the elder in LCX).

 This study using an intracoronary doppler guide wire demonstrated that there were some characteristic findings in coronary flow velocity dynamics in childhood. These physiological characteristics in coronary flow velocity dynamics must be taken into consideration at the study of the coronary circulation in children.

Copyright © 1995, Igaku-Shoin Ltd. All rights reserved.


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