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J Am Coll Cardiol, 1999; 33:1870-1878
© 1999 by the American College of Cardiology Foundation
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CLINICAL STUDIES

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

Comparison with stress myocardial perfusion imaging

Toshihiko Nishioka, MDa, Aman M. Amanullah, MD*, Huai Luo, MD*, Hans Berglund, MD*, Chong-Jin Kim, MD*, Tomoo Nagai, MD*, Naohiro Hakamata, MDa, Shuichi Katsushika, MDa, Akimi Uehata, MDa, Bonpei Takase, MDa, Kazushige Isojima, MDa, Daniel S. Berman, MD, FACC* and Robert J. Siegel, MD, FACC*

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




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Copyright © 1999 by the American College of Cardiology Foundation.