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Grading of Ischemic Response

  • Chapter
Stress Echocardiography

Abstract

The need for a dichotomic (yes/no) classification of both the results of provocative tests (positive or negative) and coronary angiography (disease present or absent) in conventional sensitivity/specificity analysis of test results has at least three important limitations [1]:

  1. 1.

    Coronary artery disease is not an “all or none” condition; a binary classification requires arbitrary threshold criteria and creates artificial distinctions in coronary artery disease, which in reality shows a continuous spectrum of severity.

  2. 2.

    Sensitivity and specificity values tend to be affected by the disease distribution in the study population; a sample distribution with a high frequency of mild disease will be placed centrally near the threshold values, where scatter is more likely to lower sensitivity and specificity [2].

  3. 3.

    Percent diameter narrowing is not an adequate standard for quantifying stenosis severity in clinical studies [3]; in unselected populations, this anatomic parameter has a poor correlation with the coronary flow reserve (see Chap. 2).

If time and space, as sages say Are things that cannot be The butterfly that lives a day Has lived as long as we ...... But time is time, and passes by Though sages disagree S. Eliot, Song

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Authors and Affiliations

  1. Institute of Clinical Physiology, CNR, Via Paolo Savi, 8, I-56126, Pisa, Italy

    Eugenio Picano MD, PhD, FESC

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  1. Eugenio Picano MD, PhD, FESC
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© 1997 Springer-Verlag Berlin Heidelberg

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Picano, E. (1997). Grading of Ischemic Response. In: Stress Echocardiography. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-10090-5_18

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  • DOI: https://doi.org/10.1007/978-3-662-10090-5_18

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-10092-9

  • Online ISBN: 978-3-662-10090-5

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