Literature DB >> 9502630

Which variable of stenosis severity best describes the significance of an isolated left anterior descending coronary artery lesion? Correlation between quantitative coronary angiography, intracoronary Doppler measurements and high dose dipyridamole echocardiography.

G B Danzi1, S Pirelli, L Mauri, R Testa, G R Ciliberto, D Massa, A A Lotto, L Campolo, O Parodi.   

Abstract

OBJECTIVES: This study sought to investigate the angiographic or intracoronary Doppler variables of stenosis severity that best correlate with the results of dipyridamole echocardiography.
BACKGROUND: Quantitative coronary angiography and intracoronary Doppler flow velocity assessments are the commonly used techniques for the objective identification of significant coronary artery stenosis.
METHODS: Thirty patients with an isolated lesion of the left anterior descending coronary artery (LAD) were studied by means of on-line quantitative coronary arteriography, intracoronary Doppler flow velocity measurements and dipyridamole echocardiography 6 months after percutaneous transluminal coronary angioplasty. The quantitative arteriographic analyses were performed on-line; post-stenotic Doppler flow velocities were measured at baseline and after adenosine infusion. Angiographic and Doppler measurements were compared with the corresponding dipyridamole echocardiographic data and analyzed by discriminant analysis.
RESULTS: The dipyridamole echocardiographic response was positive in 11 patients (37%). The best cutoff values for predicting an abnormal echocardiographic response were 1) stenotic flow reserve of 2.8 (p = 0.0001); 2) 59% diameter stenosis (p = 0.0001); 3) minimal lumen diameter of 1.35 mm (p = 0.001); 4) coronary flow reserve of 2.0 (p = 0.0002); and 5) maximal peak velocity of 60 cm/s during hyperemia (p = 0.04). Multivariate analysis identified stenotic flow reserve as the only independent predictor of ischemia during dipyridamole echocardiography.
CONCLUSIONS: Stenotic flow reserve is the variable that best describes the functional significance of an isolated LAD lesion, and a value of 2.8 is the best predictor of a positive dipyridamole echocardiographic response. Furthermore, angiographic variables of stenosis severity relate to echocardiographic test results better than intracoronary Doppler variables.

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Year:  1998        PMID: 9502630     DOI: 10.1016/s0735-1097(97)00557-3

Source DB:  PubMed          Journal:  J Am Coll Cardiol        ISSN: 0735-1097            Impact factor:   24.094


  4 in total

Review 1.  Coronary physiology assessment in the catheterization laboratory.

Authors:  Felipe Díez-Delhoyo; Enrique Gutiérrez-Ibañes; Gerard Loughlin; Ricardo Sanz-Ruiz; María Eugenia Vázquez-Álvarez; Fernando Sarnago-Cebada; Rocío Angulo-Llanos; Ana Casado-Plasencia; Jaime Elízaga; Francisco Fernández Avilés Diáz
Journal:  World J Cardiol       Date:  2015-09-26

2.  Stenotic flow reserve derived from quantitative coronary angiography has modest but incremental value in predicting functionally significant coronary stenosis as evaluated by fractional flow reserve.

Authors:  Elizabeth L Potter; Colin Machado; Yuvaraj Malaiapan; Om Narayan; Brian S H Ko; Peter J Psaltis; Kiran Munnur; James D Cameron; Ian T Meredith; Dennis Thiam Leong Wong
Journal:  Cardiovasc Diagn Ther       Date:  2017-02

Review 3.  Adequate patient selection for coronary revascularization: an overview of current methods used in daily clinical practice.

Authors:  Steven A J Chamuleau; Berthe L F van Eck-Smit; Martijn Meuwissen; Jan J Piek
Journal:  Int J Cardiovasc Imaging       Date:  2002-02       Impact factor: 2.357

Review 4.  A Practical Approach to Invasive Testing in Ischemia With No Obstructive Coronary Arteries (INOCA).

Authors:  Alexandra Bastiany; Christine Pacheco; Tara Sedlak; Jaqueline Saw; Steven E S Miner; Shuangbo Liu; Andrea Lavoie; Daniel H Kim; Martha Gulati; Michelle M Graham
Journal:  CJC Open       Date:  2022-05-04
  4 in total

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