Document Detail


Evaluation of saphenous vein coronary artery bypass graft flow by cardiovascular magnetic resonance.
MedLine Citation:
PMID:  16136852     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiovascular magnetic resonance (CMR) with flow velocity mapping has emerged as a noninvasive method to measure flow in saphenous vein coronary artery bypass grafts. The aim of the current study was to retrospectively test two previously described analysis methods on a large CMR data set and to compare their diagnostic accuracy in detecting diseased vein grafts. In 125 vein grafts of 68 patients, volume flow parameters (volume flow, systolic and diastolic peak flow, diastolic-to-systolic flow ratio at rest and during adenosine stress, and flow reserve) were derived from the velocity maps. Method 1 implemented basal flow < 20 ml/min or flow reserve < 2, yielding a sensitivity and specificity of 70% and 38% in the detection of a diseased graft or recipient vessel. Method 2 used receiver operating characteristic (ROC) curve analysis and implemented all significant volume flow parameters in a logistic regression model, yielding a sensitivity of 74% with a specificity of 68% in the detection of a diseased graft or recipient vessel. Evaluating single and sequential grafts separately, this method yielded a sensitivity and specificity of 79% and 87% for single grafts, and 62% and 94% for sequential grafts in the detection of > or = 50% stenosis in grafts or recipient vessels. Cut-off values were formulated for the respective volume flow parameters, which maximally separate grafts with and without > or = 50% stenosis. Using ROC curve analysis with logistic regression the specificity of the analysis method improved considerably. For the current data set the best results were acquired when single and sequential grafts were separately analyzed.
Authors:
Liesbeth P Salm; Hubert W Vliegen; Susan E Langerak; Jeroen J Bax; J Wouter Jukema; Hildo J Lamb; Albert de Roos; Ernst E van der Wall; Aeilko H Zwinderman
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance     Volume:  7     ISSN:  1097-6647     ISO Abbreviation:  J Cardiovasc Magn Reson     Publication Date:  2005  
Date Detail:
Created Date:  2005-09-02     Completed Date:  2006-09-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9815616     Medline TA:  J Cardiovasc Magn Reson     Country:  United States    
Other Details:
Languages:  eng     Pagination:  631-7     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. l.salm@lycos.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Algorithms
Analysis of Variance
Blood Flow Velocity
Coronary Artery Bypass*
Coronary Circulation*
Coronary Stenosis / physiopathology,  surgery
Female
Humans
Logistic Models
Magnetic Resonance Imaging*
Male
Middle Aged
Myocardial Contraction
Myocardial Infarction / physiopathology,  surgery
Predictive Value of Tests
ROC Curve
Retrospective Studies
Saphenous Vein / pathology,  physiopathology*,  transplantation*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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