Detecting and assessing severity of coronary artery disease in humans

Cardiovascular and Interventional Radiology
K L Gould

Abstract

Quantitation of stenosis severity has become an essential part of cardiac diagnosis and therapy, not only in research but also in clinical practice. Since our introduction of the concept 15 years ago, arterial coronary flow reserve for assessing effects of coronary narrowing has evolved into two independent but complementary measurements: coronary flow reserve and stenosis flow reserve. Coronary artery flow reserve and/or myocardial perfusion reserve takes into account not only stenosis geometry but also collateral function and physiologic conditions of perfusion pressure, vasomotor tone, coronary venous pressure, and myocardial vascular bed size. Coronary artery flow reserve is measured invasively by flowmeter or by Doppler catheter. Its noninvasive equivalent is myocardial perfusion reserve, assessed by myocardial perfusion imaging with positron emission tomography before and after intravenous dipyridamole with hand grip stress. Both have been experimentally and clinically validated for identifying and/or quantifying severity of coronary artery disease. By either invasive or noninvasive methods, coronary artery or myocardial perfusion reserve may be subcategorized as either absolute flow or perfusion reserve (max flow/resting...Continue Reading

References

Feb 1, 1990·Journal of the American College of Cardiology·K L GouldM Buchi
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Citations

Apr 8, 1999·Journal of the American College of Cardiology·J H CullenN J Samani
Jan 8, 2005·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Yoji NeishiKiyoshi Yoshida
Sep 1, 1993·Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine·C Y TongD Drost
Sep 1, 1994·Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine·R R EdelmanW Li
Sep 1, 1993·Journal of Magnetic Resonance Imaging : JMRI·R R EdelmanW Li
Apr 16, 1998·Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine·S DingF H Epstein
Apr 2, 2021·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Javier Escaned, Tsunekazu Kakuta

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