Clinical validation of intravascular ultrasound imaging for assessment of coronary stenosis severity - Comparison with stress myocardial perfusion imaging

OBJECTIVES To validate intravascular ultrasound (IVUS) measurements for dif ferentiating functionally significant from nonsignificant coronary stenosis . BACKGROUND To date, there are no validated criteria for the definition of a flow-limiting coronary artery stenosis by IVUS. METHODS Preinterventional IVUS imaging (30-MHz imaging catheter) of 70 de n ovo coronary lesions was performed. The lesion lumen area and three IVUS-de rived stenosis indixes comparing lesion lumen area with the lesion external elastic lamina (EEL) area, the mean reference lumen area and the mean refe rence EEL area were compared with the results of stress myocardial perfusio n imaging. RESULTS The lesion lumen area and three IVUS-derived stenosis indexes showe d sensitivities and specificities ranging between 80% and 90% using stress myocardial perfusion imaging as the gold standard. The lesion lumen area le ss than or equal to 4 mm(2) is a simple and highly accurate criterion for s ignificant coronary narrowing. CONCLUSIONS Quantitative IVUS indices can be reliably used for identifying significant epicardial coronary artery stenoses. (C) 1999 by the American C ollege of Cardiology.