Document Detail


Effect of simultaneous intracoronary guidewires on the predictive accuracy of functional parameters of coronary lesion severity.
MedLine Citation:
PMID:  17220185     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-01-12
Journal Detail:
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:
Created Date:  2007-05-09     Completed Date:  2007-06-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H2349-55     Citation Subset:  IM    
Affiliation:
Department of Nuclear Medicine, Academic Medical Center, Meibergdreef 9, 1100 DE Amsterdam, The Netherlands. h.j.verberne@amc.uva.nl
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MeSH Terms
Descriptor/Qualifier:
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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