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Correlations between quantitative cineangiography, coronary flow reserve measured with digital subtraction cineangiography and exercise thallium perfusion scintigraphy

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Summary

The goal of this investigation was to establish which anatomical parameters of stenotic lesions correlate best with its functional severity. Therefore, thirty-eight patients with single vessel disease underwent coronary cineangiography and exercise/redistribution thallium-201 scintigraphy.

Cross-sectional area at the site of obstruction (OA), percentage diameter stenosis (DS), the calculated pressuredrop over the stenosis (PD), as well as coronary flow reserve (CFR) derived from myocardial contrast appearance time and density were determined. The relations between CFR and the 3 anatomical parameters were described by the following equations:

$$\begin{gathered} CFR = 4.6 - 0.53 DS,r = 0.82, SEE:0.79, p< 0.001 \hfill \\ CFR = 0.5 + 0.75 OA,r = 0.87, SEE:0.68, p< 0.001 \hfill \\ CFR = 3.6 - 1.5 log PD,r = 0.90, SEE:0.62, p< 0.001 \hfill \\ \end{gathered} $$

The calculated pressuredrop was highly predictive of the thallium scintigraphic results with a sensitivity of 94% and a specificity of 90%. Therefore, the calculated pressuredrop is a better anatomical parameter for assessing the functional importance of a stenosis than percentage diameter stenosis or obstruction area. However, the 95% confidence limits of the relation between pressuredrop and coronary flow reserve are wide, making measurement of CFR a valuable addition to quantitative angiography, especially when determining the functional importance of moderately severe coronary artery lesions.

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Authors and Affiliations

  1. Thoraxcenter, Erasmus University and University Hospital Dijkzigt, Rotterdam, the Netherlands

    Felix Zijlstra, P. Fioretti, J. H. C. Reiber & P. W. Serruys MD

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  1. Felix Zijlstra
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  2. P. Fioretti
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  3. J. H. C. Reiber
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  4. P. W. Serruys MD
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Zijlstra, F., Fioretti, P., Reiber, J.H.C. et al. Correlations between quantitative cineangiography, coronary flow reserve measured with digital subtraction cineangiography and exercise thallium perfusion scintigraphy. Int J Cardiac Imag 3, 133–139 (1988). https://doi.org/10.1007/BF01814886

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