Comparison of Coronary Flow Velocity Reserve Measurement by Transthoracic Doppler Echocardiography With 320-Row Multidetector Computed Tomographic Coronary Angiography in the Detection of In-Stent Restenosis in the Three Major Coronary Arteries

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• 作者：Kentaro Kakuta ; MD^a ; Kaoru Dohi ; MD ; PhD^b ; ^{dohik@clin.medic.mie-u.ac.jp} ; Tomomi Yamada ; PhD^c ; Takashi Yamanaka ; MD ; PhD^a ; Masaki Kawamura ; MD ; PhD^a ; Shiro Nakamori ; MD^d ; Hiroshi Nakajima ; MD ; PhD^d ; Takashi Tanigawa ; MD ; PhD^d ; Katsuya Onishi ; MD ; PhD^d ; Norikazu Yamada ; MD ; PhD^d ; Mashio Nakamura ; MD ; PhD^d ; Tsutomu Nobori ; MD ; PhD^b ; Masaaki Ito ; MD ; PhD^d
• 刊名：The American Journal of Cardiology
• 出版年：2012
• 出版时间：1 July, 2012
• 年：2012
• 卷：110
• 期：1
• 页码：13-20
• 全文大小：1338 K

文摘

We sought to compare the diagnostic accuracy and feasibility of coronary flow velocity reserve (CFVR) measurement using transthoracic Doppler echocardiography (TTDE) and 320-row multidetector computed tomographic coronary angiography (CTCA) for predicting in-stent restenosis (ISR). We enrolled 126 consecutive patients with 309 implanted coronary stents in the 3 major coronary arteries. TTDE and CTCA were performed within the 2-week period before follow-up invasive coronary angiography. Binary ISR was defined as percent diameter stenosis ?0 % on invasive coronary angiogram. A CFVR <2.0 using TTDE and a narrowing of ?0 % measured with CTCA were the thresholds indicating the presence of binary ISR. Presence of ISR using invasive coronary angiography was observed in 26 (8 % ) stents and 26 (14 % ) vessels. Feasibilities of CFVR measurement and CTCA for predicting ISR in the 3 major vessels were 94 % and 91 % , respectively. A CFVR <2.0 revealed a 95 % diagnostic accuracy with sensitivity of 87 % , specificity of 96 % , positive predictive value of 77 % , and negative predictive value of 98 % . Diagnostic accuracy of CTCA was comparable to that of CFVR measurement; however, CTC angiographic results were confounded by metal artifacts in the assessment of small-diameter stents. In conclusion, noninvasive CFVR measurement has high feasibility and accuracy for predicting ISR and is comparable to 320-row CTCA.