Author + information
- Received August 2, 1988
- Revision received October 11, 1988
- Accepted November 3, 1988
- Published online March 15, 1989.
- Shimon A. Reisner, MD,
- Ling S. Ong, MD, FACC,
- Gerson S. Lichtenberg, RDMS,
- Janine R. Shapiro, MD,
- Antonio F. Amico, MD,
- Mark N. Allen, RDMS and
- Richard S. Meltzer, MD, PHD, FACC∗
- ↵∗Address for reprints: Richard S. Meltzer, MD, Cardiology, Box 679, University of Rochester Medical Center, Rochester, New York 14642.
A low pressure gradient across the residual lesion and a minimal percent residual stenosis are markers of a successful coronary angioplasty. A more physiologic method of assessing the results of coronary angioplasty would involve assessment of myocardial perfusion in the affected coronary bed. Contrast two-dimensional echocardiography provides information about regional myocardial perfusion. To assess the correlation between pre- to postcoronary angioplasty changes in gradient or percent stenosis and the increase in peak contrast intensity, 23 consecutive patients were studied during coronary angioplasty. In 19 of the 23 patients, the coronary angioplasty was successful and in 15 (79%) of the 19, an adequate echocardiographic study was obtained. Mild and transient side effects of echo contrast were observed in 3 of the 15 patients.
The gradient across the residual lesion decreased from 52 ± 12 to 11 ± 4 mm Hg (mean ± SD), the diameter of the stenotic lesion decreased from 89 ± 10 to 25 ± 16% and corrected peak contrast intensity (peak contrast - baseline contrast in gray level U/pixel) increased from 15 ± 16 to 50 ± 26. All these differences were significant at the p < 0.001 level.
Corrected peak contrast intensity correlated exponentially with the decrease in pressure gradient (r = 0.82, p < 0.001). The correlation curve had a greater increase in peak contrast intensity at gradient decreases >45 mm Hg. Corrected peak contrast intensity did not correlate with decrease in diameter of the stenotic lesion (r = 0.19).
☆ This work was supported in part by Grant PHS S7RR05403-26 from the National Institutes of Health, Bethesda, Maryland and by Grant SSF 27 from the New York State Science and Technology Foundation, Albany, New York.
- Received August 2, 1988.
- Revision received October 11, 1988.
- Accepted November 3, 1988.