William Wijns1, Patrick W. Serruys2, Johan H. C. Reiber3, Marcel van den Brand4, Maarten L. Simoons5, C. J. Kooijman6, K. Balakumaran7, Philip Hugenholtz8
1W Wijns
2P W Serruys
3J H Reiber
4M van den Brand
5M L Simoons
6C J Kooijman
7K Balakumaran
8P G Hugenholtz
Tóm tắt
To evaluate, during cardiac catheterization, what constitutes a physiologically significant obstruction to blood flow in the human coronary system, computer-based quantitative analysis of coronary angiograms was performed on the angiograms of 31 patients with isolated disease of the proximal left anterior descending coronary artery. The angiographic severity of stenosis was compared with the transstenotic pressure gradient measured with the dilation catheter during angioplasty and with the results of exercise thallium scintigraphy. A curvilinear relationship was found between the pressure gradient across the stenosis (normalized for the mean aortic pressure) and the residual minimal area of obstruction (after subtracting the area of the angioplasty catheter). This relationship was best fitted by the equation: normalized mean pressure gradient = a + b . log [obstruction area], r = .74. The measurements of the percent area of stenosis (cutoff 80%) and of the transstenotic pressure gradient (cutoff 0.30) obtained at rest correctly predicted the occurrence of thallium perfusion defects induced by exercise in 83% of the patients.
