Assessment of short-, medium-, and long-term variations in arterial dimensions from computer-assisted quantitation of coronary cineangiograms.

Reiber, Johan H. C.; Serruys, Patrick W.; Kooijman, C. J.; Wijns, William; Slager, Cornelis J.; Gerbrands, Jan J.; Schuurbiers, Johan C.H.; Boer, Ad den; Hugenholtz, Paul G.

doi:10.1161/01.cir.71.2.280

Cited by 796 publications

(213 citation statements)

References 36 publications

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“…The minimal lumen diameter (MLD), distal reference, proximal reference, reference diameter (RD), percentage of diameter stenosis (%DS), and lesion length with the least foreshortening view were measured using standard techniques. 19 The coronary lesions were then classified into 2 groups according to the QCA data results as follows: (1) intermediate stenosis (group I): 40% to 70% stenosis; (2) significant stenosis (group S): ≥70% stenosis.…”

Section: Angiographic Measurementsmentioning

confidence: 99%

Impact of Lesion Length on Functional Significance in Intermediate Coronary Lesions

Iguchi

Hasegawa

Nishimura

et al. 2012

Clinical Cardiology

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Background: Myocardial fractional flow reserve (FFR) is useful in the evaluation of coronary lesion ischemia. However, the impact of lesion length on FFR has not been adequately assessed. Hypothesis: We hypothesized that lesion length would influence functional significance in intermediate coronary lesions. Methods: FFR measurements were assessed in 136 patients (163 lesions) with stable angina who had >40% stenotic coronary lesion by quantitative coronary angiography (QCA). One hundred sixty-three lesions were classified as intermediate (40%-70% stenosis; n=107; group I) or significant (≥70%; n=56; group S) by QCA. We assessed the relationships between lesion length, coronary stenosis, and FFR in these 163 lesions. Results: Regression analysis revealed an inverse correlation between the percentage of diameter stenosis (%DS) and FFR in group S (r = −0.83, P < 0.0001). In group I, no significant correlation was found between %DS and FFR (r = −0.06, P = 0.55), whereas lesion length was significantly inversely correlated with FFR (r = −0.79, P < 0.0001). Receiver operating characteristic curve analysis demonstrated that the best cutoff value for predicting an FFR value <0.80 was a lesion length >16.1 mm in group I (sensitivity, 86%; specificity, 94%). Conclusions: These study findings suggest that lesion length has a physiologically significant impact on intermediate-grade coronary lesions.

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Section: Angiographic Measurementsmentioning

confidence: 99%

Impact of Lesion Length on Functional Significance in Intermediate Coronary Lesions

Iguchi

Hasegawa

Nishimura

et al. 2012

Clinical Cardiology

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“…Postmortem human coronary angiograms do not recreate in vivo motion. As a result, the repeatability of coronary image processing has been extensively reported 63 in lieu of tests for accuracy in truly representing the coronary status. There is general agreement that coronary angiography in humans underestimates coronary artery disease compared with postmortem specimens.…”

Section: Future Directions Improved Computerized Image Processingmentioning

confidence: 99%

George Lyman Duff Memorial Lecture. Arterial imaging and atherosclerosis reversal.

Blankenhorn

Hodis

1994

Arterioscler Thromb

202

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This review explores evidence for the reversibility of atherosclerosis and augmentation of angiography with noninvasive arterial wall imaging. Meta-analysis from coronary angiographic trials demonstrates that regression and stabilization are 1.5 to 2 times more common in treated than placebo subjects, and progression is reduced by half in treated subjects. Odds ratios for clinical coronary events are significantly reduced with treatment. Lesion improvement occurs more readily in women than men and more so in women receiving concomitant estrogen replacement therapy. Lesions with >50% diameter stenosis (%S) at baseline respond more readily to lipid lowering than those <50%S, whereas reduction in coronary events is related to stabilization of lesions <50%S. Lipoproteins have a differential effect on lesion progression according to lesion size, and triglyceride-rich lipoproteins play an important role in the progression of coronary artery lesions <50%S. Improved therapeutic regimens to alter progression of atherosclerosis may require adjunctive therapy, such as with antioxidants or hormone replacement therapy, in concert with low-density lipoprotein cholesterol reduction to prevent new lesion formation or early lesion progression. Sequential coronary angiographic determination of progression evaluated by both quantitative coronary angiography and global change score, a visual assessment of overall lesion change, predicts clinical coronary events. Only inferences about the state of the arterial wall can be made from angiography, because it delineates only the lumen. Therapy testing and study of atherosclerosis progression can be improved with noninvasive B-mode ultrasonographic imaging of the distal common carotid artery far-wall intima-media thickness (IMT), a reliable measure of early preintrusive atherosclerosis. Measurement of common carotid IMT is useful for the study of coronary artery risk factors and can augment studies of coronary artery intrusive lesions, because it is associated with coronary artery disease. B-mode measurement of common carotid IMT has the potential of serving as a noninvasive surrogate end point for clinical coronary events. Screening for peripheral vessel changes indicative of high risk for coronary artery disease is possible and cost-effective with the noninvasive procedures now available. (Arterioscler Thromb. 1994;14:177-192.) Key Words • atherosclerosis • angiography • ultrasound • regression • clinical trials • intima-media thickness • quantitative computerized angiography • common carotid artery • coronary arteries • meta-analysis E vidence that progression of atherosclerosis can be retarded and atherosclerotic lesions can regress derives from several sources. These sources include studies of arterial lesions obtained at autopsy from starved human populations, animal experimentation, and clinical trials using serial angiography. In the first half of this article, we review serial angiographic evidence for atherosclerotic lesion improvement induced by diverse modes of int...

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“…In our retrospective data base,1' patients meeting the age and extent score criteria listed in Table 1 had an 80% probability of coronary disease progression in 2-4 years. Thus, these criteria Placebo (n = 191) 50.0+8.4 157 (82) 61 (32) 3 (1.6) 135 (71) 46 (24) (26) 32 (17) 90 (47) 60 (31) 9 (4.7) 6.98 +1.47 1.05+0.26 114 (60) 10 (5.2) 29 (15) 4 (2.1) 28 (15) 14 (7.3) 35 (18) 54 (28) 73 (38) 29 (15) 30.6±38. 6 97 (25) 65 (17) 160 (42) 146 (38) (16) 21 (5.5) 56 (15) 108 (28) 146 (38) 73 (19) …”

Section: Patient Selectionmentioning

confidence: 99%

A controlled clinical trial to assess the effect of a calcium channel blocker on the progression of coronary atherosclerosis.

et al. 1990

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To determine whether calcium channel blockers influence the progression of coronary atherosclerosis, 383 patients age 65 years or less with 5-75% stenoses in at least four coronary artery segments were selected at random within 1 Ninety-two nicardipine patients (55%) and 95 placebo patients (57%) had progression at one or more sites (p=NS). Regression, that is, an improvement by l1o0 or more in diameter stenosis, was seen in 140 of 2,323 lesions (6.0%) overall, with no significant intergroup difference. Among the 217 patients with 411 stenoses of 20% or less in the first study, such minimal lesions progressed in only 15 of 99 nicardipine patients compared with 32 of 118 placebo patients (15% versus 27%, p =0.046). In this subgroup, 16 of 178 minimal lesions in nicardipine patients and 38 of 233 minimal lesions in placebo patients progressed (p=0.038). By stepwise logisticregression analysis, baseline systolic blood pressure (p=0.04) and the change in systolic blood pressure between baseline and 6 months (p=0.002) correlated with progression of minimal lesions. This suggested blood pressure reduction may account for the beneficial action of nicardipine. These results suggested nicardipine has no effect on advanced coronary atherosclerosis but may retard the progression of minimal lesions. (Circulation 1990;82:1940-1953 Several calcium channel blockers have been shown to retard the development of athero-1, sclerosis in rabbits fed cholesterol-rich diets.1-7 The mechanism through which these drugs exert their antiatherogenic effects is not known, but is being From the

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Assessment of short-, medium-, and long-term variations in arterial dimensions from computer-assisted quantitation of coronary cineangiograms.

Abstract: A computer-assisted technique has been developed to assess absolute coronary arterial dimensions from 35 mm cineangiograms.

Cited by 796 publications

References 36 publications

Impact of Lesion Length on Functional Significance in Intermediate Coronary Lesions

Impact of Lesion Length on Functional Significance in Intermediate Coronary Lesions

George Lyman Duff Memorial Lecture. Arterial imaging and atherosclerosis reversal.

A controlled clinical trial to assess the effect of a calcium channel blocker on the progression of coronary atherosclerosis.

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