Document Detail


How good are experienced cardiologists at predicting the hemodynamic severity of coronary stenoses when taking fractional flow reserve as the gold standard.
MedLine Citation:
PMID:  12108911     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Coronary angioplasty should be based on documented ischemia. However, in daily clinical practice the indication for angioplasty is often based on eyeball assessment of the severity of the stenosis. This study was performed to assess the accuracy of eyeball estimation of coronary stenosis when taking functional flow reserve (FFR) as gold standard. METHODS: Study lesions were where no mutual agreement on the severity of the stenosis was obtained. The procedure consisted of a repeat control angiogram, FFR measurement and in case of FFR<75% percutaneous coronary intervention. The eyeball assessment of the stenosis was written down before further execution of the procedure. FFR was measured with a pressure monitoring guide. Maximal myocardial hyperemia was induced by intravenous adenosine infusion. RESULTS: Fifty-two patients were studied. Agreement between eyeball assessment and FFR existed in a total of 36 cases (69.2%). Over estimation of hemodynamic severity occurred in six cases (11.5%) and under estimation in 10 cases (19.2%). Consequently, the positive predictive value of eyeball assessment for pressure-derived FFR was 63% and the negative predictive value 76%. CONCLUSION: The assessment of the hemodynamic severity of intermediate coronary stenosis should not be based on eyeball assessment even by experienced interventional cardiologists.
Authors:
B R G Brueren; J M ten Berg; M J Suttorp; E T Bal; J M P G Ernst; E G Mast; H W M Plokker
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The international journal of cardiovascular imaging     Volume:  18     ISSN:  1569-5794     ISO Abbreviation:  Int J Cardiovasc Imaging     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-07-10     Completed Date:  2002-12-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100969716     Medline TA:  Int J Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  73-6     Citation Subset:  IM    
Affiliation:
Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Circulation*
Coronary Stenosis / diagnosis,  physiopathology,  radiography*
Female
Humans
Male
Predictive Value of Tests
Risk Factors

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