T. Tsuchiya et al., Quantitative assessment of diffuse coronary artery disease using a three-dimensional reconstruction method compared with intravascular ultrasound images, CORON ART D, 12(2), 2001, pp. 127-133
Background It can be difficult to estimate the degree of stenosis in patien
ts with diffuse coronary artery disease (CAD), because of the lack of a nor
mal reference segment. If the size of normal coronary lumen has a direct re
lation to size of distal myocardial bed, it could be used to estimate the '
normal' cross-sectional area of coronary lumen. Accordingly, we could estim
ate the degree of stenosis of coronary arteries with diffuse disease by com
paring them with calculated 'normal' areas of lumen.
Objective To assess the validity of the above hypothesis.
Method Fourteen subjects without coronary atherosclerosis (group A) and 16
patients with CAD (group B) underwent simultaneous bidirectional coronary a
rteriography. Using these coronary arteriograms, we determined the relation
ship between cross-sectional area of coronary lumen measured by using a com
puterized edge-detection system and summed distal branch length calculated
by using our computerized three-dimensional reconstruction method.
Results For group A, we found a dose correlation between area of lumen and
branch length (r = 0.948). However, for group B, there were some segments f
or which the measured area of lumen was clearly smaller than that expected
from the relationship for group A. From this relationship for group A, we c
alculated the stenosis ratios of 22 segments and, to confirm their accuracy
, we compared the stenotic ratios with those measured on intravascular ultr
asound images. The stenotic ratio of each segment of stenotic coronary arte
ry calculated by our method agreed significantly well with the results obta
ined from the ultrasound measurements (r = 0.980).
Conclusions These observations validate a novel approach to quantifying dif
fuse CAD using clinical arteriograms. Coron Artery Dis 12:127-133 (C) 2001
Lippincott Williams & Wilkins.