Angiographical and Doppler flow-derived parameters for assessment of coronary lesion severity and its relation to the result of exercise electrocardiography

J. J. Piek, E. Boersma, C. Di Mario, E. Schroeder, C. Vrints, P. Probst, B. De Bruyne, C. Hanet, E. Fleck, M. Haude, E. Verna, V. Voudris, H. Geschwind, H. Emanuelsson, V. Mühlberger, H. O. Peels, P. W. Serruys

Research output: Contribution to journalArticle

Abstract

Aims. Evaluation of angiographical and intracoronary Doppler-derived parameters of coronary stenosis severity. Methods and Results. A total of 225 patients with one-vessel disease were studied before PTCA and at 6 months follow-up. Exercise electrocardiography was performed to document presence (n = 157) or absence (n = 138) of an ST segment shift (≥ 0.1 mV). Intracoronary blood flow velocity analysis was performed to determine the proximal/distal flow velocity ratio, the distal diastolic/systolic flow velocity ratio and coronary flow velocity reserve. Receiver operator characteristic curves were calculated to assess the predictive value of these variables compared with the exercise test. The distal coronary flow velocity reserve demonstrated the best linear correlation for both percentage diameter stenosis and minimum lumen diameter (r = 0.67 and r = 0.66; P < 0.01), compared to the diastolic/systolic flow velocity ratio (r = 0.19 and r = 0.14; P < 0.01) and the proximal/distal flow velocity ratio (r = 0.03 and r = 0.07; not significant). The areas under the curve were 0.84 ± 0.02; 0.82 ± 0.03 and 0.83 ± 0.03 for diameter stenosis, minimum lumen diameter and coronary flow velocity reserve, respectively. Logistic regression analysis revealed that the percentage diameter stenosis or minimum lumen diameter and coronary flow velocity reserve were independent predictors for the result of stress testing. Conclusions. The distal coronary flow velocity reserve is the best intracoronary Doppler parameter for evaluation of coronary narrowings. Angiographical estimates of coronary lesion severity and distal coronary flow velocity reserve are good and independent predictors for the assessment of functional severity of coronary stenosis, emphasizing the complementary role of these parameters for clinical decision making. (C) 2000 The European Society of Cardiology.

Original languageEnglish
Pages (from-to)466-474
Number of pages9
JournalEuropean Heart Journal
Volume21
Issue number6
DOIs
Publication statusPublished - 15 Mar 2000
Externally publishedYes

Keywords

  • Angiography
  • Coronary stenosis
  • Exercise electrocardiography
  • Intracoronary Doppler

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    Piek, J. J., Boersma, E., Di Mario, C., Schroeder, E., Vrints, C., Probst, P., De Bruyne, B., Hanet, C., Fleck, E., Haude, M., Verna, E., Voudris, V., Geschwind, H., Emanuelsson, H., Mühlberger, V., Peels, H. O., & Serruys, P. W. (2000). Angiographical and Doppler flow-derived parameters for assessment of coronary lesion severity and its relation to the result of exercise electrocardiography. European Heart Journal, 21(6), 466-474. https://doi.org/10.1053/euhj.1999.1871