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Hemodynamic evaluation of saphenous vein coronary artery bypass grafts: Relative merits of Doppler flow velocity and SPECT perfusion imaging
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, a...
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| Published in: | Journal of nuclear cardiology 2005-09, Vol.12 (5), p.545-552 |
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| container_end_page | 552 |
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| container_title | Journal of nuclear cardiology |
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| creator | Salm, Liesbeth P. Bax, Jeroen J. Jukema, J. Wouter Langerak, Susan E. Vliegen, Hubert W. Steendijk, Paul Lamb, Hildo J. de Roos, Albert van der Wall, Ernst E. |
| description | 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.
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 ( |
| doi_str_mv | 10.1016/j.nuclcard.2005.04.015 |
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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 (≥50%) (n = 29). When a cutoff value for coronary flow velocity reserve (CFVR) of 1.8 was applied, modest agreement (69%, κ = 0.25,
P < .05) between CFVR and angiography was shown. Agreement between SPECT and angiography was also modest (63%, κ = 0.28,
P = not significant). SPECT and CFVR provided comparable information in 20 of 24 grafts with available SPECT, illustrating good agreement (83%, κ = 0.61,
P = .001).
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.</description><identifier>ISSN: 1071-3581</identifier><identifier>EISSN: 1532-6551</identifier><identifier>DOI: 10.1016/j.nuclcard.2005.04.015</identifier><identifier>PMID: 16171714</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Agreements ; Blood Flow Velocity ; Cardiology ; Coronary Angiography - statistics & numerical data ; Coronary Artery Bypass - statistics & numerical data ; coronary artery bypass grafting ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - epidemiology ; Coronary Artery Disease - surgery ; Coronary flow velocity reserve ; Coronary vessels ; Female ; Flow velocity ; Hemodynamics ; Humans ; Incidence ; Laser-Doppler Flowmetry - statistics & numerical data ; Male ; Medical imaging ; Reproducibility of Results ; Risk Assessment - methods ; Risk Factors ; Saphenous Vein - diagnostic imaging ; Saphenous Vein - transplantation ; Sensitivity and Specificity ; single photon emission computed tomography ; Stents ; Tomography, Emission-Computed, Single-Photon - statistics & numerical data ; Ultrasonography ; Veins & arteries</subject><ispartof>Journal of nuclear cardiology, 2005-09, Vol.12 (5), p.545-552</ispartof><rights>2005 American Society of Nuclear Cardiology</rights><rights>American Society of Nuclear Cardiology 2005.</rights><rights>American Society of Nuclear Cardiology 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c421t-7742ed69cb9ff42c7dc5693588b772bd696fab58ac9961b5947121e937aab07b3</citedby><cites>FETCH-LOGICAL-c421t-7742ed69cb9ff42c7dc5693588b772bd696fab58ac9961b5947121e937aab07b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16171714$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Salm, Liesbeth P.</creatorcontrib><creatorcontrib>Bax, Jeroen J.</creatorcontrib><creatorcontrib>Jukema, J. Wouter</creatorcontrib><creatorcontrib>Langerak, Susan E.</creatorcontrib><creatorcontrib>Vliegen, Hubert W.</creatorcontrib><creatorcontrib>Steendijk, Paul</creatorcontrib><creatorcontrib>Lamb, Hildo J.</creatorcontrib><creatorcontrib>de Roos, Albert</creatorcontrib><creatorcontrib>van der Wall, Ernst E.</creatorcontrib><title>Hemodynamic evaluation of saphenous vein coronary artery bypass grafts: Relative merits of Doppler flow velocity and SPECT perfusion imaging</title><title>Journal of nuclear cardiology</title><addtitle>J Nucl Cardiol</addtitle><description>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.
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 (≥50%) (n = 29). When a cutoff value for coronary flow velocity reserve (CFVR) of 1.8 was applied, modest agreement (69%, κ = 0.25,
P < .05) between CFVR and angiography was shown. Agreement between SPECT and angiography was also modest (63%, κ = 0.28,
P = not significant). SPECT and CFVR provided comparable information in 20 of 24 grafts with available SPECT, illustrating good agreement (83%, κ = 0.61,
P = .001).
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.</description><subject>Aged</subject><subject>Agreements</subject><subject>Blood Flow Velocity</subject><subject>Cardiology</subject><subject>Coronary Angiography - statistics & numerical data</subject><subject>Coronary Artery Bypass - statistics & numerical data</subject><subject>coronary artery bypass grafting</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - epidemiology</subject><subject>Coronary Artery Disease - surgery</subject><subject>Coronary flow velocity reserve</subject><subject>Coronary vessels</subject><subject>Female</subject><subject>Flow velocity</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Incidence</subject><subject>Laser-Doppler Flowmetry - statistics & numerical data</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Reproducibility of Results</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Saphenous Vein - diagnostic imaging</subject><subject>Saphenous Vein - transplantation</subject><subject>Sensitivity and Specificity</subject><subject>single photon emission computed tomography</subject><subject>Stents</subject><subject>Tomography, Emission-Computed, Single-Photon - statistics & numerical data</subject><subject>Ultrasonography</subject><subject>Veins & arteries</subject><issn>1071-3581</issn><issn>1532-6551</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><recordid>eNqFkd-K1DAUxou4uOvqKyxBwbt2k7ZJGq9cxv0jLCi6Xoc0PR0ztElN2pF5Bx96zzAjgiBLLk4gv-875-TLsgtGC0aZuNwUfrGDNbErSkp5QeuCMv4sO2O8KnPBOXuOdypZXvGGnWYvU9pQSlWl1IvslAkm8dRn2e87GEO382Z0lsDWDIuZXfAk9CSZ6Qf4sCSyBeeJDTF4E3fExBmwtLvJpETW0fRzek--woDKLZARopvT3uBjmKYBIumH8As9hmDdjHLfkW9frlcPZILYL2nfzY1m7fz6VXbSmyHB62M9z77fXD-s7vL7z7efVlf3ua1LNudS1iV0QtlW9X1dWtlZLhTu2bRSli2-iN60vDFWKcFarmrJSgaqksa0VLbVefbu4DvF8HOBNOvRJQvDYDzgvlo0XCklBYJv_gE3YYkeZ9OyqkWj0Buht_-DStnIkqNRhZQ4UDaGlCL0eoq4dtxpRvU-Ur3RfyLV-0g1rTVGisKLo_3SjtD9lR0zRODDAQD8sq2DqJN14C10LoKddRfcUz0eAehQt10</recordid><startdate>20050901</startdate><enddate>20050901</enddate><creator>Salm, Liesbeth P.</creator><creator>Bax, Jeroen J.</creator><creator>Jukema, J. 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Wouter</au><au>Langerak, Susan E.</au><au>Vliegen, Hubert W.</au><au>Steendijk, Paul</au><au>Lamb, Hildo J.</au><au>de Roos, Albert</au><au>van der Wall, Ernst E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hemodynamic evaluation of saphenous vein coronary artery bypass grafts: Relative merits of Doppler flow velocity and SPECT perfusion imaging</atitle><jtitle>Journal of nuclear cardiology</jtitle><addtitle>J Nucl Cardiol</addtitle><date>2005-09-01</date><risdate>2005</risdate><volume>12</volume><issue>5</issue><spage>545</spage><epage>552</epage><pages>545-552</pages><issn>1071-3581</issn><eissn>1532-6551</eissn><abstract>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.
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 (≥50%) (n = 29). When a cutoff value for coronary flow velocity reserve (CFVR) of 1.8 was applied, modest agreement (69%, κ = 0.25,
P < .05) between CFVR and angiography was shown. Agreement between SPECT and angiography was also modest (63%, κ = 0.28,
P = not significant). SPECT and CFVR provided comparable information in 20 of 24 grafts with available SPECT, illustrating good agreement (83%, κ = 0.61,
P = .001).
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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>16171714</pmid><doi>10.1016/j.nuclcard.2005.04.015</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged Agreements Blood Flow Velocity Cardiology Coronary Angiography - statistics & numerical data Coronary Artery Bypass - statistics & numerical data coronary artery bypass grafting Coronary Artery Disease - diagnosis Coronary Artery Disease - epidemiology Coronary Artery Disease - surgery Coronary flow velocity reserve Coronary vessels Female Flow velocity Hemodynamics Humans Incidence Laser-Doppler Flowmetry - statistics & numerical data Male Medical imaging Reproducibility of Results Risk Assessment - methods Risk Factors Saphenous Vein - diagnostic imaging Saphenous Vein - transplantation Sensitivity and Specificity single photon emission computed tomography Stents Tomography, Emission-Computed, Single-Photon - statistics & numerical data Ultrasonography Veins & arteries |
| title | Hemodynamic evaluation of saphenous vein coronary artery bypass grafts: Relative merits of Doppler flow velocity and SPECT perfusion imaging |
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