Which variable of stenosis severity best describes the significance of an isolated left anterior descending coronary artery lesion? Correlation between quantitative coronary angiography, intracoronary Doppler measurements and high dose dipyridamole echocardiography.
Which variable of stenosis severity best describes the significance of an isolated left anterior descending coronary artery lesion? Correlation between quantitative coronary angiography, intracoronary Doppler measurements and high dose dipyridamole echocardiography.
复制标题
哪个狭窄严重程度变量最能描述孤立性冠状动脉左前降支病变的重要性？
DOI：
10.1016/s0735-1097(97)00557-3
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发表时间：
1998
影响因子：
24
通讯作者：
Oberdan Parodi
中科院分区：
文献类型：
--
作者：
G. Danzi;Salvatore Pirelli;Luigi Mauri;Roberto Testa;G. R. Ciliberto;Daria Massa;A. Lotto;Luigi Campolo;Oberdan Parodi
目标。本研究旨在探讨血管造影或冠状动脉内多普勒变量与双嘧达莫超声心动图结果最相关的狭窄严重程度。定量冠状动脉造影和冠状动脉内多普勒血流速度评估是客观识别显著冠状动脉狭窄的常用技术。通过在线定量冠状动脉造影、冠状动脉内多普勒血流速度测量和双嘧达莫超声心动图对30例孤立性冠状动脉左前降支病变患者在经皮冠状动脉腔内成形术后6个月的表现进行了研究。在线进行定量动脉造影分析；在基线和腺苷输注后测量狭窄后多普勒血流速度。将血管造影和多普勒测量结果与相应的双嘧达莫超声心动图数据进行比较，并进行判别分析。11例（37%）患者双嘧达莫超声心动图反应阳性。预测超声心动图异常反应的最佳临界值为：1)狭窄血流储备2.8 (p = 0.0001)；2) 59%内径狭窄（p = 0.0001）；3)最小管腔直径1.35 mm (p = 0.001)；4)冠状动脉血流储备2.0 (p = 0.0002)；充血时最大峰值速度为60 cm/s （p = 0.04）。多因素分析表明，狭窄血流储备是双嘧达莫超声心动图中唯一独立的缺血预测指标。狭窄血流储备是最能描述孤立LAD病变功能意义的变量，2.8值是双嘧达莫超声心动图阳性反应的最佳预测指标。此外，狭窄严重程度的血管造影变量与超声心动图检查结果的相关性优于冠状动脉内多普勒变量。
Objectives. This study sought to investigate the angiographic or intracoronary Doppler variables of stenosis severity that best correlate with the results of dipyridamole echocardiography.Background. Quantitative coronary angiography and intracoronary Doppler flow velocity assessments are the commonly used techniques for the objective identification of significant coronary artery stenosis.Methods. Thirty patients with an isolated lesion of the left anterior descending coronary artery (LAD) were studied by means of on-line quantitative coronary arteriography, intracoronary Doppler flow velocity measurements and dipyridamole echocardiography 6 months after percutaneous transluminal coronary angioplasty. The quantitative arteriographic analyses were performed on-line; post-stenotic Doppler flow velocities were measured at baseline and after adenosine infusion. Angiographic and Doppler measurements were compared with the corresponding dipyridamole echocardiographic data and analyzed by discriminant analysis.Results. The dipyridamole echocardiographic response was positive in 11 patients (37%). The best cutoff values for predicting an abnormal echocardiographic response were 1) stenotic flow reserve of 2.8 (p = 0.0001); 2) 59% diameter stenosis (p = 0.0001); 3) minimal lumen diameter of 1.35 mm (p = 0.001); 4) coronary flow reserve of 2.0 (p = 0.0002); and 5) maximal peak velocity of 60 cm/s during hyperemia (p = 0.04). Multivariate analysis identified stenotic flow reserve as the only independent predictor of ischemia during dipyridamole echocardiography.Conclusions. Stenotic flow reserve is the variable that best describes the functional significance of an isolated LAD lesion, and a value of 2.8 is the best predictor of a positive dipyridamole echocardiographic response. Furthermore, angiographic variables of stenosis severity relate to echocardiographic test results better than intracoronary Doppler variables.
影响因子：
37.8
作者：
AMBROSIO, G;WEISMAN, HF;BECKER, LC
通讯作者：
BECKER, LC
评估患者冠状动脉阻塞的生理意义：弥漫性未检测到的动脉粥样硬化的重要性。
影响因子：
9.1
作者：
Marcus,ML;Harrison,DG;White,CW;McPherson,DD;Wilson,RF;Kerber,RE
通讯作者：
Kerber,RE