Author/Authors :
Kakuta، نويسنده , , Kentaro and Dohi، نويسنده , , Kaoru and Yamada، نويسنده , , Tomomi and Yamanaka، نويسنده , , Takashi and Kawamura، نويسنده , , Masaki and Nakamori، نويسنده , , Shiro and Nakajima، نويسنده , , Hiroshi and Tanigawa، نويسنده , , Takashi and Onishi، نويسنده , , Katsuya and Yamada، نويسنده , , Norikazu and Nakamura، نويسنده , , Mashio and Nobori، نويسنده , , Tsutomu and Ito، نويسنده , , Masaak، نويسنده ,
Abstract :
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 ≥50% on invasive coronary angiogram. A CFVR <2.0 using TTDE and a narrowing of ≥50% 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.