Comparison of coronary flow velocity reserve measurement by transthoracic Doppler echocardiography with 320-row multidetector computed tomographic coronary angiography in the detection of in-stent restenosis in the three major coronary arteries |
| |
Authors: | Kakuta Kentaro Dohi Kaoru Yamada Tomomi Yamanaka Takashi Kawamura Masaki Nakamori Shiro Nakajima Hiroshi Tanigawa Takashi Onishi Katsuya Yamada Norikazu Nakamura Mashio Nobori Tsutomu Ito Masaaki |
| |
Institution: | Department of Cardiology, Yokkaichi Social Insurance Hospital, Yokkaichi, Japan. |
| |
Abstract: | We sought to compare the diagnostic accuracy and feasibility of coronary flow velocity reserve (CFVR) measurement using transthoracic Doppler echocardiography (TTDE) and 320-row multidetector computed tomographic coronary angiography (CTCA) for predicting in-stent restenosis (ISR). We enrolled 126 consecutive patients with 309 implanted coronary stents in the 3 major coronary arteries. TTDE and CTCA were performed within the 2-week period before follow-up invasive coronary angiography. Binary ISR was defined as percent diameter stenosis ≥50% on invasive coronary angiogram. A CFVR <2.0 using TTDE and a narrowing of ≥50% measured with CTCA were the thresholds indicating the presence of binary ISR. Presence of ISR using invasive coronary angiography was observed in 26 (8%) stents and 26 (14%) vessels. Feasibilities of CFVR measurement and CTCA for predicting ISR in the 3 major vessels were 94% and 91%, respectively. A CFVR <2.0 revealed a 95% diagnostic accuracy with sensitivity of 87%, specificity of 96%, positive predictive value of 77%, and negative predictive value of 98%. Diagnostic accuracy of CTCA was comparable to that of CFVR measurement; however, CTC angiographic results were confounded by metal artifacts in the assessment of small-diameter stents. In conclusion, noninvasive CFVR measurement has high feasibility and accuracy for predicting ISR and is comparable to 320-row CTCA. |
| |
Keywords: | |
本文献已被 ScienceDirect PubMed 等数据库收录! |
|