BACKGROUND: Coronary angioplasty should be based on documented ischemia. However, in daily clinical practice the indication for angioplasty is often based on eyeball assessment of the severity of the stenosis. This study was performed to assess the accuracy of eyeball estimation of coronary stenosis when taking functional flow reserve (FFR) as gold standard. METHODS: Study lesions were where no mutual agreement on the severity of the stenosis was obtained. The procedure consisted of a repeat control angiogram, FFR measurement and in case of FFR<75% percutaneous coronary intervention. The eyeball assessment of the stenosis was written down before further execution of the procedure. FFR was measured with a pressure monitoring guide. Maximal myocardial hyperemia was induced by intravenous adenosine infusion. RESULTS: Fifty-two patients were studied. Agreement between eyeball assessment and FFR existed in a total of 36 cases (69.2%). Over estimation of hemodynamic severity occurred in six cases (11.5%) and under estimation in 10 cases (19.2%). Consequently, the positive predictive value of eyeball assessment for pressure-derived FFR was 63% and the negative predictive value 76%. CONCLUSION: The assessment of the hemodynamic severity of intermediate coronary stenosis should not be based on eyeball assessment even by experienced interventional cardiologists.
BACKGROUND: Coronary angioplasty should be based on documented ischemia. However, in daily clinical practice the indication for angioplasty is often based on eyeball assessment of the severity of the stenosis. This study was performed to assess the accuracy of eyeball estimation of coronary stenosis when taking functional flow reserve (FFR) as gold standard. METHODS: Study lesions were where no mutual agreement on the severity of the stenosis was obtained. The procedure consisted of a repeat control angiogram, FFR measurement and in case of FFR<75% percutaneous coronary intervention. The eyeball assessment of the stenosis was written down before further execution of the procedure. FFR was measured with a pressure monitoring guide. Maximal myocardial hyperemia was induced by intravenous adenosine infusion. RESULTS: Fifty-two patients were studied. Agreement between eyeball assessment and FFR existed in a total of 36 cases (69.2%). Over estimation of hemodynamic severity occurred in six cases (11.5%) and under estimation in 10 cases (19.2%). Consequently, the positive predictive value of eyeball assessment for pressure-derived FFR was 63% and the negative predictive value 76%. CONCLUSION: The assessment of the hemodynamic severity of intermediate coronary stenosis should not be based on eyeball assessment even by experienced interventional cardiologists.
Authors: P J Scanlon; D P Faxon; A M Audet; B Carabello; G J Dehmer; K A Eagle; R D Legako; D F Leon; J A Murray; S E Nissen; C J Pepine; R M Watson; J L Ritchie; R J Gibbons; M D Cheitlin; T J Gardner; A Garson; R O Russell; T J Ryan; S C Smith Journal: J Am Coll Cardiol Date: 1999-05 Impact factor: 24.094
Authors: G J Bech; B De Bruyne; H J Bonnier; J Bartunek; W Wijns; K Peels; G R Heyndrickx; J J Koolen; N H Pijls Journal: J Am Coll Cardiol Date: 1998-03-15 Impact factor: 24.094
Authors: P W Serruys; C Di Mario; N Meneveau; P de Jaegere; S Strikwerda; P J de Feyter; H Emanuelsson Journal: Am J Cardiol Date: 1993-05-20 Impact factor: 2.778
Authors: C W White; C B Wright; D B Doty; L F Hiratza; C L Eastham; D G Harrison; M L Marcus Journal: N Engl J Med Date: 1984-03-29 Impact factor: 91.245
Authors: B De Bruyne; T Baudhuin; J A Melin; N H Pijls; S U Sys; A Bol; W J Paulus; G R Heyndrickx; W Wijns Journal: Circulation Date: 1994-03 Impact factor: 29.690
Authors: E J Topol; S G Ellis; D M Cosgrove; E R Bates; D W Muller; N J Schork; M A Schork; F D Loop Journal: Circulation Date: 1993-05 Impact factor: 29.690
Authors: Noha El-Baz; Daniela Ondusova; Martin Studencan; Jaroslav Rosenberger; Sijmen A Reijneveld; Jitse P van Dijk; Berrie Middel Journal: Eur J Cardiovasc Nurs Date: 2017-12-12 Impact factor: 3.908