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Hemodynamic evaluation of saphenous vein coronary artery bypass grafts: relative merits of Doppler flow velocity and SPECT perfusion imaging.
- Source :
-
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology [J Nucl Cardiol] 2005 Sep-Oct; Vol. 12 (5), pp. 545-52. - Publication Year :
- 2005
-
Abstract
- Background: Coronary angiography is considered the gold standard in evaluating vein graft disease; however, angiography does not allow assessment of hemodynamic consequences of lesions. In this study hemodynamic consequences of significant stenoses in vein grafts were evaluated by Doppler velocity assessment, and results were compared with single photon emission computed tomography (SPECT) perfusion imaging.<br />Methods and Results: Angiography was performed in 58 patients after coronary artery bypass grafting because of recurrent chest pain. During the procedure, Doppler velocity measurements were acquired before and after administration of adenosine. Of 58 patients (with 78 vein grafts), 20 patients (with 24 vein grafts) underwent SPECT perfusion imaging. Grafts were divided into those with nonsignificant percent diameter stenosis (< 50%) (n = 49) and those with significant percent diameter stenosis (> or =50%) (n = 29). When a cutoff value for coronary flow velocity reserve (CFVR) of 1.8 was applied, modest agreement (69%, kappa = 0.25, P < .05) between CFVR and angiography was shown. Agreement between SPECT and angiography was also modest (63%, kappa = 0.28, P = not significant). SPECT and CFVR provided comparable information in 20 of 24 grafts with available SPECT, illustrating good agreement (83%, kappa = 0.61, P = .001).<br />Conclusions: Significant stenoses in vein grafts require further exploration to assess their hemodynamic significance. The Doppler velocity results agreed better with SPECT perfusion imaging than with percent diameter stenosis in the evaluation of vein graft function.
- Subjects :
- Aged
Blood Flow Velocity
Coronary Artery Disease surgery
Female
Humans
Incidence
Male
Reproducibility of Results
Risk Factors
Saphenous Vein diagnostic imaging
Saphenous Vein transplantation
Sensitivity and Specificity
Ultrasonography
Coronary Angiography statistics & numerical data
Coronary Artery Bypass statistics & numerical data
Coronary Artery Disease diagnosis
Coronary Artery Disease epidemiology
Laser-Doppler Flowmetry statistics & numerical data
Risk Assessment methods
Tomography, Emission-Computed, Single-Photon statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1071-3581
- Volume :
- 12
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 16171714
- Full Text :
- https://doi.org/10.1016/j.nuclcard.2005.04.015