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

Gian Battista Danzi, Salvatore Pirelli, Luigi Mauri, Roberto Testa, Guglielma R. Ciliberto, Daria Massa, Attilio A. Lotto, Luigi Campolo, Oberdan Parodi

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)526-533
Number of pages8
JournalJournal of the American College of Cardiology
Volume31
Issue number3
DOIs
Publication statusPublished - Mar 1998

Fingerprint

Dipyridamole
Coronary Angiography
Echocardiography
Coronary Vessels
Pathologic Constriction
Coronary Balloon Angioplasty
Coronary Stenosis
Hyperemia
Discriminant Analysis
Adenosine
Angiography
Multivariate Analysis
Ischemia

ASJC Scopus subject areas

  • Nursing(all)

Cite this

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. / Danzi, Gian Battista; Pirelli, Salvatore; Mauri, Luigi; Testa, Roberto; Ciliberto, Guglielma R.; Massa, Daria; Lotto, Attilio A.; Campolo, Luigi; Parodi, Oberdan.

In: Journal of the American College of Cardiology, Vol. 31, No. 3, 03.1998, p. 526-533.

Research output: Contribution to journalArticle

Danzi, Gian Battista ; Pirelli, Salvatore ; Mauri, Luigi ; Testa, Roberto ; Ciliberto, Guglielma R. ; Massa, Daria ; Lotto, Attilio A. ; Campolo, Luigi ; Parodi, Oberdan. / 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. In: Journal of the American College of Cardiology. 1998 ; Vol. 31, No. 3. pp. 526-533.
@article{03fb2871526b4f28a397bea5d06c4ad1,
title = "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",
abstract = "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.",
author = "Danzi, {Gian Battista} and Salvatore Pirelli and Luigi Mauri and Roberto Testa and Ciliberto, {Guglielma R.} and Daria Massa and Lotto, {Attilio A.} and Luigi Campolo and Oberdan Parodi",
year = "1998",
month = "3",
doi = "10.1016/S0735-1097(97)00557-3",
language = "English",
volume = "31",
pages = "526--533",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - 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

AU - Danzi, Gian Battista

AU - Pirelli, Salvatore

AU - Mauri, Luigi

AU - Testa, Roberto

AU - Ciliberto, Guglielma R.

AU - Massa, Daria

AU - Lotto, Attilio A.

AU - Campolo, Luigi

AU - Parodi, Oberdan

PY - 1998/3

Y1 - 1998/3

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0032030826&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032030826&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(97)00557-3

DO - 10.1016/S0735-1097(97)00557-3

M3 - Article

VL - 31

SP - 526

EP - 533

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 3

ER -