| Hyperemic stenosis resistance index for evaluation of functional coronary lesion severity. | |
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MedLine Citation:
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PMID: 12135943 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Both coronary blood flow velocity reserve (CFVR) and myocardial fractional flow reserve (FFR) are used to evaluate the hemodynamic severity of coronary lesions. However, discordant results between CFVR and FFR have been observed in 25% to 30% of intermediate coronary lesions. An index of stenosis resistance based on a combination of intracoronary pressure and flow velocity may improve the assessment of functional coronary lesion severity. METHODS AND RESULTS: Single photon emission computed tomography (SPECT) was performed in 151 patients with angina to determine reversible perfusion defects within one-week before cardiac catheterization. Coronary pressure and flow velocity was measured distal to 181 single coronary lesions with a mean diameter stenosis of 56% (range: 32% to 85%). Maximum hyperemia was induced by 15 to 20 microg IC adenosine to determine CFVR, FFR, and the hyperemic stenosis resistance index (h-SRv), defined as the ratio of hyperemic stenosis pressure gradient (mean aorta pressure-mean distal pressure) and hyperemic average peak-flow velocity. Receiver-operating-characteristic curves of CFVR, FFR, and h-SRv were calculated to evaluate the predictive value for presence of reversible perfusion defects on SPECT with the use of the area under curve (AUC). The AUC was significantly higher for h-SRv (0.90+/-0.03) compared with those for CFVR (0.80+/-0.04; P=0.024) and FFR (0.82+/-0.03; P=0.018), respectively. Agreement with SPECT was particularly higher (73%) than for CFVR (49%, P=0.022) or FFR (51%, P=0.037) in the group of lesions showing discordant results between CFVR and FFR CONCLUSION: These results indicate that hyperemic stenosis resistance index is a more powerful predictor of reversible perfusion defects than CFVR or FFR. |
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Authors:
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Martijn Meuwissen; Maria Siebes; Steven A J Chamuleau; Berthe L F van Eck-Smit; Karel T Koch; Robbert J de Winter; Jan G P Tijssen; Jos A E Spaan; Jan J Piek |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 106 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2002 Jul |
Date Detail:
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Created Date: 2002-07-23 Completed Date: 2002-08-07 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 441-6 Citation Subset: AIM; IM |
Affiliation:
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Departments of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Flow Velocity Coronary Angiography Coronary Circulation* Coronary Stenosis / diagnosis*, physiopathology, radiography, radionuclide imaging Diagnostic Errors Female Humans Hyperemia / diagnosis, physiopathology, radiography Male Middle Aged Regional Blood Flow Tomography, Emission-Computed, Single-Photon Vascular Resistance |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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