Document Detail

Intracoronary electrocardiogram ST segment shift evaluation during intravenous adenosine infusion: A comparison with fractional flow reserve.
MedLine Citation:
PMID:  22113754     Owner:  NLM     Status:  In-Data-Review    
Background: By measuring the pressure decline caused by coronary narrowing, fractional flow reserve (FFR) is an index of the physiological significance of a vessel stenosis. Intracoronary electrocardiogram (IC-ECG) recording from an angioplasty guidewire is more sensitive than standard ECG in detecting regional myocardial ischemia. The aim of the study was to assess if unipolar IC-ECG ST segment recording from angioplasty guidewire during maximal pharmacologic vasodilation could be used as an indirect estimation of FFR results. Methods: Forty-eight clinically stable patients with intermediate stenosis underwent FFR evaluation and IC-ECG recording during intravenous adenosine infusion. Results: FFR values were ≤ 0.80 in 26 (54%) patients and 〉 0.80 in 22 (46%). After adenosine, standard ECG was abnormal in only nine (19%) patients, while IC-ECG showed a significant ST segment shift (IST) in 24 (50%) patients: ST elevation in 19 patients and depression in five). IST was documented in 21/26 patients with FFR ≤ 0.80 (81%) and in 3/22 with FFR 〉 0.80 (p 〈 0.001). Sensitivity of IST for predicting an abnormal FFR value was 81%, specificity 86%, positive and negative predictive accuracies were 88% and 79%, respectively. Conclusions: Intracoronary ST segment shift evaluation during adenosine infusion may be of value in assessing the functional significance of a borderline stenosis. The presence of IST during adenosine infusion could obviate the need for additional FFR evaluation. (Cardiol J 2011; 18, 6: 662-667).
Vruyr Balian; Claudio Marcassa; Michele Galli; Gianni Cecchin; Riccardo Michi; Marco Crenna; Ettore Petrucci; Marco Onofri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiology journal     Volume:  18     ISSN:  1897-5593     ISO Abbreviation:  Cardiol J     Publication Date:  2011  
Date Detail:
Created Date:  2011-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  662-7     Citation Subset:  IM    
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