| Coronary pressure notch: an early non-hyperemic visual indicator of the physiologic significance of a coronary artery stenosis. | |
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MedLine Citation:
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PMID: 15550728 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The disappearance of a dichrotic notch on the peripheral arterial pulse wave has been associated with significant peripheral vascular disease. A similar observation has not been reported in the distal coronary pressure waveform. The purpose of this study was to investigate the significance of a coronary pressure notch distal to a coronary stenosis and its relationship to fractional flow reserve. Ninety-seven patients with 131 angiographically indeterminate lesions (40-80% diameter narrowing) underwent FFR measurements for physiological significance. Hemodynamic tracings were recorded prior to the administration of adenosine and visually analyzed for the presence or absence of a dicrotic notch in the distal coronary artery pressure tracing. The stenoses were then divided into two groups based on the presence or absence of a notch. Of the 54 lesions without a distal coronary pressure notch, 31 had a FFR greater than or equal to 0.75 and of the 77 lesions with a notch, 75 had a FFR greater than or equal to 0.76. The sensitivity and specificity of a pressure notch was 94% and 74%, respectively, with positive and negative predictive values of 57% and 97%, respectively. The presence of a distal coronary pressure notch was predictive of a FFR greater than or equal to 0.76. The distal dicrotic pressure notch may be used as an additional parameter without requiring hyperemia for FFR measurements of uncertain clinical significance. |
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Authors:
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David Holmes; Priya Velappan; Morton J Kern |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Journal of invasive cardiology Volume: 16 ISSN: 1042-3931 ISO Abbreviation: J Invasive Cardiol Publication Date: 2004 Nov |
Date Detail:
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Created Date: 2004-11-19 Completed Date: 2005-01-24 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8917477 Medline TA: J Invasive Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 617-20 Citation Subset: IM |
Affiliation:
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J.G. Mudd Cardiac Catheterization Lab, St. Louis University Hospital, 3635 Vista Avenue at Grand Blvd., Saint Louis, MO 63110, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Aged Blood Flow Velocity / physiology Cohort Studies Coronary Angiography / methods* Coronary Circulation / physiology* Coronary Stenosis / physiopathology, radiography* Female Hemodynamics / physiology Humans Hyperemia / radiography Male Middle Aged Predictive Value of Tests Pressure Prognosis Prospective Studies Pulse ROC Curve Risk Assessment Sensitivity and Specificity Severity of Illness Index Sex Factors Vascular Resistance / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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