| Effect of simultaneous intracoronary guidewires on the predictive accuracy of functional parameters of coronary lesion severity. | |
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MedLine Citation:
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PMID: 17220185 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The aim of this study was to assess the influence of a second guidewire on the diagnostic accuracy of functional parameters of coronary lesion severity. Sixty-five patients with intermediate coronary lesions underwent myocardial perfusion scintigraphy. Fractional flow reserve (FFR), coronary flow velocity reserve (CFVR), and hyperemic stenosis resistance (HSR) index (HSR = stenosis pressure gradient / velocity) were determined in 77 lesions. Distal pressure and velocity were acquired simultaneously (dual wire) and sequentially (single wire) with two sensor-equipped guidewires. Overall, functional parameters deteriorated from single- to dual-wire assessment. In patients without ischemia, the good diagnostic performance of FFR, CFVR, and HSR deteriorated significantly (P < 0.001) when assessed by dual wires, with an increase in the number of false-positive results. This trend was more pronounced for HSR, since the presence of a second wire reduced maximal velocity and increased the pressure gradient. The presence of two guidewires, especially across a myocardial perfusion scintigraphy-induced nonsignificant lesion, is associated with overestimation of the hemodynamically assessed lesion severity and, therefore, is likely to have a major impact on clinical decision making. This underscores the advantage of a dual-sensor-equipped guidewire for the evaluation of stenosis severity by combined pressure and velocity measurements. |
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Authors:
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Hein J Verberne; Martijn Meuwissen; Steven A J Chamuleau; Bart-Jan Verhoeff; Berthe L F van Eck-Smit; Jos A E Spaan; Jan J Piek; Maria Siebes |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2007-01-12 |
Journal Detail:
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Title: American journal of physiology. Heart and circulatory physiology Volume: 292 ISSN: 0363-6135 ISO Abbreviation: Am. J. Physiol. Heart Circ. Physiol. Publication Date: 2007 May |
Date Detail:
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Created Date: 2007-05-09 Completed Date: 2007-06-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100901228 Medline TA: Am J Physiol Heart Circ Physiol Country: United States |
Other Details:
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Languages: eng Pagination: H2349-55 Citation Subset: IM |
Affiliation:
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Department of Nuclear Medicine, Academic Medical Center, Meibergdreef 9, 1100 DE Amsterdam, The Netherlands. h.j.verberne@amc.uva.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Coronary Circulation* Coronary Stenosis / classification, diagnosis*, physiopathology* Female Heart Catheterization / methods* Humans Male Middle Aged Reproducibility of Results Sensitivity and Specificity Severity of Illness Index* Vascular Resistance |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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