Related Experiment Videos
Videodensitometric analysis of coronary stenoses. In vivo geometric and physiologic validation in humans
M R Johnson1, D J Skorton, E E Ericksen
1Department of Internal Medicine, Loyola University Medical Center, Maywood, IL 60153.
Insights
Computerized videodensitometry accurately estimates coronary luminal area, predicting the physiological significance of coronary artery disease. This method offers a promising supplement to traditional stenosis assessments.
Area of Science:
- Cardiovascular imaging
- Interventional cardiology
- Medical diagnostics
Background:
- Conventional assessment of coronary stenosis severity relies on subjective diameter narrowing estimates.
- Studies show a poor correlation between subjective percent stenosis and the physiological significance of coronary obstructions in multivessel disease.
Purpose of the Study:
- To determine if computerized videodensitometry can estimate coronary luminal area.
- To predict the physiological significance of individual coronary stenoses using videodensitometry.
Main Methods:
- Videodensitometry was used to define minimal luminal area in 45 coronary artery segments from 43 patients.
- Computer-assisted quantitative coronary arteriography determined minimal luminal cross-sectional area.
- Coronary vasodilator reserve was assessed using Doppler measurements.
Main Results:
- Videodensitometric estimates of luminal area strongly correlated with quantitative coronary arteriography measurements (r=0.82).
- Videodensitometry also correlated well with lesion physiological significance, assessed by peak-to-resting velocity ratio (r=0.71-0.92).
Conclusions:
- Computerized videodensitometry is a promising tool for quantitative analysis of coronary arteriograms.
- This technique may supplement existing geometric methods for assessing coronary stenosis severity and physiological significance.
Abstract:
Assessment of the severity of coronary stenoses on arteriograms conventionally is based on subjective estimates of percent luminal diameter narrowing. However, in studies in patients with multivessel coronary artery disease, we have found a poor correlation between percent stenosis and the physiologic significance of an individual coronary obstruction. The purpose of this study was to determine whether computerized videodensitometry would allow estimation of coronary luminal area and therefore prediction of the physiologic significance of individual coronary stenoses in humans. Videodensitometry was used to define the minimal luminal area of 15 left anterior descending, 15 circumflex, and 15 right coronary artery segments in 43 patients. Computer-assisted quantitative coronary arteriography (method of Brown et al) was used to determine the minimal luminal cross-sectional area of these same segments. In each arterial segment, coronary vasodilator reserve was assessed using intraoperative (n = 18 segments) or intracoronary (n = 27 segments) Doppler measurements of coronary vasodilator reserve. Videodensitometric estimates of coronary luminal area correlated well with minimal luminal area defined using the independent geometric technique of quantitative coronary arteriography (r = 0.82, y = 0.97 X + 0.71, SEE = 1.83 mm2, n = 45) and with lesion physiologic significance as defined by studies of the peak-to-resting velocity ratio (r = 0.71, 0.92, and 0.74 for the left anterior descending, circumflex, and right coronary arteries, respectively). Thus, videodensitometry is a promising method that may supplement geometric approaches to quantitative analysis of coronary arteriograms in humans.