This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nishioka, T. Articles by Siegel, R. J. Search for Related Content PubMed PubMed Citation Articles by Nishioka, T. Articles by Siegel, R. J.

CLINICAL STUDIES

Clinical validation of intravascular ultrasound imaging for assessment of coronary stenosis severity

Comparison with stress myocardial perfusion imaging

^a Division of Cardiology, Self-Defense Forces Central Hospital, Setagaya-ku, Tokyo 154-8532, Japan
^* Division of Cardiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, California 90048, USA

Manuscript received August 18, 1997; revised manuscript received January 22, 1999, accepted February 10, 1999.

Reprint requests and correspondence: Dr. Robert J. Siegel, Division of Cardiology, Room 5335, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, California 90048
siegel{at}CSHS.ORG

OBJECTIVES

To validate intravascular ultrasound (IVUS) measurements for differentiating functionally significant from nonsignificant coronary stenosis.

BACKGROUND

To date, there are no validated criteria for the definition of a flow-limiting coronary artery stenosis by IVUS.

METHODS

Preinterventional IVUS imaging (30-MHz imaging catheter) of 70 de novo coronary lesions was performed. The lesion lumen area and three IVUS-derived stenosis indixes comparing lesion lumen area with the lesion external elastic lamina (EEL) area, the mean reference lumen area and the mean reference EEL area were compared with the results of stress myocardial perfusion imaging.

RESULTS

The lesion lumen area and three IVUS-derived stenosis indexes showed sensitivities and specificities ranging between 80% and 90% using stress myocardial perfusion imaging as the gold standard. The lesion lumen area 4 mm² is a simple and highly accurate criterion for significant coronary narrowing.

CONCLUSIONS

Quantitative IVUS indices can be reliably used for identifying significant epicardial coronary artery stenoses.

Abbreviations and Acronyms   ANOVA = analysis of variance   EEL = external elastic lamina   IVUS = intravascular ultrasound   NTG = nitroglycerin   SPECT = single-photon emission computed tomography

This article has been cited by other articles:

				T. A. Bass and P. Capranzano Managing Patients With Intermediate In-Stent Restenotic Lesions: Is It "Prime Time" for Intravascular Ultrasound Imaging? Circ Cardiovasc Interv, October 1, 2008; 1(2): 90 - 92. [Full Text] [PDF]

				H. Doi, A. Maehara, G. S. Mintz, N. J. Weissman, A. Yu, H. Wang, L. Mandinov, J. J. Popma, S. G. Ellis, E. Grube, et al. Impact of In-Stent Minimal Lumen Area at 9 Months Poststent Implantation on 3-Year Target Lesion Revascularization-Free Survival: A Serial Intravascular Ultrasound Analysis From the TAXUS IV, V, and VI Trials Circ Cardiovasc Interv, October 1, 2008; 1(2): 111 - 118. [Abstract] [Full Text] [PDF]

				A. Sato, M. Hiroe, M. Tamura, H. Ohigashi, T. Nozato, H. Hikita, A. Takahashi, K. Aonuma, and M. Isobe Quantitative Measures of Coronary Stenosis Severity by 64-Slice CT Angiography and Relation to Physiologic Significance of Perfusion in Nonobese Patients: Comparison with Stress Myocardial Perfusion Imaging J. Nucl. Med., April 1, 2008; 49(4): 564 - 572. [Abstract] [Full Text] [PDF]

				J. D. Schuijf, J. M. van Werkhoven, G. Pundziute, J. W. Jukema, I. Decramer, M. P. Stokkel, P. Dibbets-Schneider, M. J. Schalij, J. H.C. Reiber, E. E. van der Wall, et al. Invasive versus noninvasive evaluation of coronary artery disease. J. Am. Coll. Cardiol. Img., March 1, 2008; 1(2): 190 - 199. [Abstract] [Full Text] [PDF]

				U. Elkayam, T. M.H. Ng, P. Hatamizadeh, M. Janmohamed, and A. Mehra Renal Vasodilatory Action of Dopamine in Patients With Heart Failure: Magnitude of Effect and Site of Action Circulation, January 15, 2008; 117(2): 200 - 205. [Abstract] [Full Text] [PDF]

				J. Tobis, B. Azarbal, and L. Slavin Assessment of Intermediate Severity Coronary Lesions in the Catheterization Laboratory J. Am. Coll. Cardiol., February 27, 2007; 49(8): 839 - 848. [Abstract] [Full Text] [PDF]

				G. S. Mintz and N. J. Weissman Intravascular Ultrasound in the Drug-Eluting Stent Era J. Am. Coll. Cardiol., August 1, 2006; 48(3): 421 - 429. [Abstract] [Full Text] [PDF]

				M. L. E. Vicario, L. Cirillo, G. Storto, T. Pellegrino, N. Ragone, L. Fontanella, M. Petretta, D. Bonaduce, and A. Cuocolo Influence of Risk Factors on Coronary Flow Reserve in Patients with 1-Vessel Coronary Artery Disease J. Nucl. Med., September 1, 2005; 46(9): 1438 - 1443. [Abstract] [Full Text] [PDF]

				G. Rioufol, M. Gilard, G. Finet, I. Ginon, J. Boschat, and X. Andre-Fouet Evolution of Spontaneous Atherosclerotic Plaque Rupture With Medical Therapy: Long-Term Follow-Up With Intravascular Ultrasound Circulation, November 2, 2004; 110(18): 2875 - 2880. [Abstract] [Full Text] [PDF]

				F. SCHIELE The "angioplastically correct" follow up strategy after stent implantation Heart, April 1, 2001; 85(4): 363 - 364. [Full Text]

				S. Atar, T. Nagai, B. Cercek, T. Z. Naqvi, H. Luo, and R. J. Siegel Pacing stress echocardiography: an alternative to pharmacologic stress testing J. Am. Coll. Cardiol., November 15, 2000; 36(6): 1935 - 1941. [Abstract] [Full Text] [PDF]