Document Detail

Hemodynamic evaluation of saphenous vein coronary artery bypass grafts: relative merits of Doppler flow velocity and SPECT perfusion imaging.
MedLine Citation:
PMID:  16171714     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Coronary angiography is considered the gold standard in evaluating vein graft disease; however, angiography does not allow assessment of hemodynamic consequences of lesions. In this study hemodynamic consequences of significant stenoses in vein grafts were evaluated by Doppler velocity assessment, and results were compared with single photon emission computed tomography (SPECT) perfusion imaging. METHODS AND RESULTS: Angiography was performed in 58 patients after coronary artery bypass grafting because of recurrent chest pain. During the procedure, Doppler velocity measurements were acquired before and after administration of adenosine. Of 58 patients (with 78 vein grafts), 20 patients (with 24 vein grafts) underwent SPECT perfusion imaging. Grafts were divided into those with nonsignificant percent diameter stenosis (< 50%) (n = 49) and those with significant percent diameter stenosis (> or =50%) (n = 29). When a cutoff value for coronary flow velocity reserve (CFVR) of 1.8 was applied, modest agreement (69%, kappa = 0.25, P < .05) between CFVR and angiography was shown. Agreement between SPECT and angiography was also modest (63%, kappa = 0.28, P = not significant). SPECT and CFVR provided comparable information in 20 of 24 grafts with available SPECT, illustrating good agreement (83%, kappa = 0.61, P = .001). CONCLUSIONS: Significant stenoses in vein grafts require further exploration to assess their hemodynamic significance. The Doppler velocity results agreed better with SPECT perfusion imaging than with percent diameter stenosis in the evaluation of vein graft function.
Liesbeth P Salm; Jeroen J Bax; J Wouter Jukema; Susan E Langerak; Hubert W Vliegen; Paul Steendijk; Hildo J Lamb; Albert de Roos; Ernst E van der Wall
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  12     ISSN:  1071-3581     ISO Abbreviation:  J Nucl Cardiol     Publication Date:    2005 Sep-Oct
Date Detail:
Created Date:  2005-09-20     Completed Date:  2006-01-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  545-52     Citation Subset:  IM    
Department of Cardiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands.
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MeSH Terms
Blood Flow Velocity
Coronary Angiography / statistics & numerical data*
Coronary Artery Bypass / statistics & numerical data*
Coronary Artery Disease / diagnosis*,  epidemiology*,  surgery
Laser-Doppler Flowmetry / statistics & numerical data*
Reproducibility of Results
Risk Assessment / methods*
Risk Factors
Saphenous Vein / radionuclide imaging,  transplantation,  ultrasonography
Sensitivity and Specificity
Tomography, Emission-Computed, Single-Photon / statistics & numerical data*
Comment In:
J Nucl Cardiol. 2005 Sep-Oct;12(5):520-2   [PMID:  16171710 ]

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