Importance of Visual Estimation of Coronary Artery Stenoses and Use of Functional Evaluation for Appropriate Guidance of Coronary Revascularization-Multiple Operator Evaluation
| Autor: | Vlad Ploscaru, Lucian Itu, Alexandru Scafa-Udriste, Irina Andra Tache, Diana Stoian, Maria Dorobantu, Vlad Bataila, Elisabeta Badila, Nicoleta-Monica Popa-Fotea, Lucian Calmac, Adrian Turea |
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| Rok vydání: | 2021 |
| Předmět: |
Medicine (General)
medicine.medical_specialty Clinical Biochemistry Fractional flow reserve Article cardiac imaging Coronary artery disease diameter stenosis R5-920 Operator (computer programming) Internal medicine functional evaluation medicine Visual estimation fractional flow reserve visual estimation agreement coronary artery disease inter-observer variability group decision myocardial ischemia Cardiac imaging Functional evaluation business.industry medicine.disease Stenosis medicine.anatomical_structure Cardiology business Artery |
| Zdroj: | Diagnostics Diagnostics; Volume 11; Issue 12; Pages: 2241 Diagnostics, Vol 11, Iss 2241, p 2241 (2021) |
| ISSN: | 2075-4418 |
| Popis: | Background: Visual estimation (VE) of coronary stenoses is the first step during invasive coronary angiography. The aim of this study was to evaluate the accuracy of VE together with invasive functional assessment (IFA) in defining the functional significance (FS) of coronary stenoses based on the opinion of multiple operators. Methods: Fourteen independent operators visually evaluated 133 coronary lesions which had a previous FFR measurement, indicating the degree of stenosis (DS), FS and IFA intention. We determined the accuracy of FS prediction using several scenarios combining individual and group decision, considering IFA as deemed necessary by the operator or only in intermediate lesions. Results: The accuracy of VE in predicting FS was largely variable between operators (average 66.1%); it improved significantly when IFA was used either as per operator’s opinion (86.3%; p < 0.0001) or only in intermediate DS (82.9; p < 0.0001). There was no significant difference between using IFA per observer’s opinion or only in intermediate DS lesions (p = 0.166). The poorest accuracy of VE for FS was obtained in intermediate DS lesions (59.1%). Conclusions: There are significant inter-observer differences in reporting the degree of DS, while the accuracy of VE prediction of FS is also largely dependent on the operator, and the worst performance is obtained in the evaluation of intermediate DS. |
| Databáze: | OpenAIRE |
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