Validation in dogs of a rapid digital angiographic technique to measure relative coronary blood flow during routine cardiac catheterization

Hodgson, John Mc B.; Legrand, Victor; Bates, Eric R.; Mancini, G.B.John; Aueron, Fred M.; O’Neill, William W.; Simon, Sandra B.; Beauman, Glenn J.; LeFree, Michael T.; Vogel, Robert A.

doi:10.1016/0002-9149(85)90326-1

Cited by 134 publications

(21 citation statements)

References 21 publications

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“…33,34 These semiquantitative methods have also been applied in the setting of acute myocardial infarction 35 but are cumbersome, time consuming, and difficult to apply in routine clinical practice. However, qualitative visual assessment is feasible and applicable in routine clinical practice, because reproducibility and the variability of this method allow its use in clinical practice until more sophisticated techniques have been proven to be superior.…”

Section: The Myocardial Blush Gradementioning

confidence: 99%

Angiographic Assessment of Reperfusion in Acute Myocardial Infarction by Myocardial Blush Grade

et al. 2003

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Background-Angiographic successful reperfusion in acute myocardial infarction has been defined as TIMI 3 flow.However, TIMI 3 flow does not always result in effective myocardial reperfusion. Myocardial blush grade (MBG) is an angiographic measure of myocardial perfusion. We hypothesized that optimal angiographic reperfusion is defined by TIMI 3 flow and MBG 2 or 3. Methods and Results-In 924 consecutive patients with TIMI 3 flow after angioplasty for acute myocardial infarction, we prospectively studied the value of MBG. End points were death, MACE, enzymatic infarct size, and residual left ventricular ejection fraction. Follow-up was 16Ϯ11 months. Of the 924 patients, 101 (11%) patients had MBG 0 or 1. Mortality was significantly higher in patients with MBG 0 or 1 compared with patients with MBG 2 or 3 (relative risk, 4.7; 95% CI, 2.3 to 9.5; PϽ0.001).

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Section: The Myocardial Blush Gradementioning

confidence: 99%

Angiographic Assessment of Reperfusion in Acute Myocardial Infarction by Myocardial Blush Grade

et al. 2003

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“…Subsequently, a separate analysis of the myocardium was carried out analogous to previous work by others in which an average measurement of appearance time for multiple pixels was performed. 10 1 For this analysis, eight interactively selected regions of interest were positioned along the course of the circumflex coronary artery over the myocardium perfused by this vessel.…”

Section: Methodsmentioning

confidence: 99%

Value and limitations of computer analysis of digital subtraction angiography in the assessment of coronary flow reserve.

Nissen¹,

Élion²,

Booth³

et al. 1986

Circulation

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Circulation 73, No. 3, 562-571, 1986. CORONARY ARTERIOGRAPHY is the primary modality used to identify and select therapy for patients with coronary artery disease. However, currently available techniques for assessing the magnitude and functional significance of coronary atherosclerotic stenoses by angiography have significant limitations. A variety of imaging problems, including overlapping of vessels and influence of collateral blood flow, have been demonstrated to interfere significantly with the

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“…A variety of anatomic and physiologic methods have been used to evaluate the initial success of coronary angioplasty (PTCA) [1][2][3][4][5][6][7][8][9][10][11]. Coronary flow reserve (CFR), measured by digital subtraction angiography or by an intracoronary doppler catheter, improves in most patients immediately after PTCA [1-5], but does not consistently return to the value observed in normal arteries [1, 2,4].…”

Section: Introductionmentioning

confidence: 99%

“…Coronary flow reserve (CFR), measured by digital subtraction angiography or by an intracoronary doppler catheter, improves in most patients immediately after PTCA [1-5], but does not consistently return to the value observed in normal arteries [1, 2,4]. While failure of CFR to normalize after PTCA has been attributed to diffuse atherosclerosis in the involved coronary artery [1], late increases in CFR have been noted months after PTCA in some patients [1,4]. Moreover, the angiographic appearance of the dilated vessel after PTCA may often fail to detect a physiologically significant coronary artery obstruction as manifested by an abnormally low coronary flow reserve ratio [1, 2,4] or residual thallium defect [12].…”

Section: Introductionmentioning

confidence: 99%

Variability of coronary flow reserve obtained immediately after coronary angioplasty

1990

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Coronary flow reserve (CFR) improves in most patients immediately following coronary angioplasty (PTCA). The degree of improvement, however, may be variable and its predictive value for a favorable long-term angiographic result is unknown. To evaluate these issues, we used digital subtraction angiography to measure CFR in 15 patients before and immediately after PTCA. Minimum coronary diameter improved and percent diameter stenosis was reduced immediately following PTCA (from 0.75 +/- 0.35 mm to 2.19 +/- 0.56 mm, and from 74 +/- 12% to 27 +/- 15%, respectively; p less than 0.001). While CFR improved in patients immediately following PTCA (from 1.49 +/- 0.75 to 2.68 +/- 1.73; p less than 0.05), a substantial variability in CFR measurements (range 0.80 to 8.33) was present. At repeat arteriography 2.9 +/- 0.6 months later, 4 patients demonstrated restenosis. Compared with the 11 patients without restenosis, those with restenosis had similar coronary dimensions and CFRs immediately following PTCA. We conclude that coronary flow reserve, determined by digital subtraction angiography, improves in most patients immediately after PTCA but the degree of improvement is variable. Its ability to predict long-term angiographic outcome remains uncertain.

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Validation in dogs of a rapid digital angiographic technique to measure relative coronary blood flow during routine cardiac catheterization

Cited by 134 publications

References 21 publications

Angiographic Assessment of Reperfusion in Acute Myocardial Infarction by Myocardial Blush Grade

Angiographic Assessment of Reperfusion in Acute Myocardial Infarction by Myocardial Blush Grade

Value and limitations of computer analysis of digital subtraction angiography in the assessment of coronary flow reserve.

Variability of coronary flow reserve obtained immediately after coronary angioplasty

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