Author + information
- Received December 27, 1990
- Revision received April 2, 1991
- Accepted April 23, 1991
- Published online October 1, 1991.
- Richard M. Fleming, MD,
- Richard L. Kirkeeide, PhD,
- Richard W. Smalling, MD, PhD, FACC,
- K.Lance Gould, MD, FACC∗ and
- Yvonne Stuart, RT
- ↵∗Address for reprints: K. Lance Gould, MD, Division of Cardiology, Suite 4.256, The University of Texas Medical School, 6431 Fannin Street, Houston, Texas 77030.
In part 1 of a three-part study, 14 novice readers and 6 experienced cardiologists interpreted phantom images of known stenosis severity. No difference between the interpretations of experienced and novice readers was detectable. Visual estimates of “moderately” severe stenosis were 30% higher than actual percent diameter stenosis.
In part 2 of the study, visual interpretation of percent diameter stenosis from 212 stenoses on 241 arteriograms was compared with quantitative coronary arteriographic assessment. The visual analysis overestimated disease severity in arteries with ≥50% diameter stenosis (except for right coronary lesions) and underestimated severity in all arteries with <50% diameter stenosis. Of the 241 arteriograms, 40 had quantitative and visual analysis of all three coronary arteries for assessment of significant disease. In only 62% of the cases did visual and quantitative methods agree on the presence of severe disease; visual estimates diagnosed significantly (p < 0.05) more three-vessel disease.
In part 3 of the study, comparison of percent diameter stenosis by visual estimate with quantitative coronary arteriographic assessment before and after balloon angioplasty of 38 stenoses showed that visual interpretation significantly (p < 0.001) overestimated initial lesion severity and underestimated stenosis severity after angioplasty.
☆ This study was supported in part by Grants R01HL2682 and R01HL26885 from the National Institutes of Health, Bethesda, Maryland.
- Received December 27, 1990.
- Revision received April 2, 1991.
- Accepted April 23, 1991.