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Quantitative coronary and left ventricular cineangiography: methodology and clinical applications. Johnston et al. USB2 en. Intermediate density marker and a method using such a marker for radiographic examination. Whaites et al. JPB2 ja. WOA1 en.

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Pages Densitometric analysis coronary cineangiograms Pages 3-D reconstruction of coronary arterial segments from two projections Pages Structural analysis of the coronary and retinal arterial tree Pages A methodological review of quantification systems for coronary and left ventricular cineangiograms Pages Quantitative Assessment of regional left ventricular function: endocardial landmark motion Pages The cardiovascular database and the coronary reporting system Pages Front Matter Pages Influence of intracoronary nifedipine on left ventricular function, coronary vasomotility, and myocardial oxygen consumption Pages Effect of intracoronary thrombolytic therapy on global and regional left ventricular function.

A three years experience with randomization Pages Effect of coronary occlusion during percutaneous transluminal angioplasty in man on left ventricular chamber stiffness and regional diastolic pressure-radius relations Pages Is transluminal coronary angioplasty mandatory after successful thrombolysis? A quantitative coronary angiographic study Pages Assessment of percutaneous transluminal coronary angioplasty by quantitative coronary angiography: diameter versus densitometric area measurements Pages Left ventricular performance, regional blood flow, wall motion and lactate metabolism during transluminal angioplasty Pages The role of vascular wall thickening during changes in coronary artery tone Pages Responses of normal and obstructed coronary arterial segments to cold stimulation; a quantitative angiographic study Pages Quantitative angiography of the left anterior descending coronary artery: correlations with pressure gradient and exercise thallium scintigraphy Pages Asynchrony in regional filling dynamics as a consequence of uncoordinated segmental contraction during coronary transluminal occlusion Pages Back Matter Quantitative coronary angiography has been widely used for decades in clinical research and, in selected cases, in clinical practice, owing to its reproducibility and validity.

However, our findings remained robust when we excluded complex lesions. Furthermore, based on the Appropriate Use Criteria, angiographic determination of stenosis severity remains a cornerstone in revascularization decisions. There are potential remedies to the limitations of QCA. There is evidence that group reading can improve the accuracy of interpretations. Moreover, there may be ways to easily incorporate some of the principles of QCA into real-time practice, such as a standardized calibration process using specific catheters.

Also, feedback to practitioners, enabling calibration of their interpretations, might be useful—as might be computerized training programs. In addition, the development of machine-learning techniques 22 may provide tools to help physicians interpret coronary stenosis more accurately. Finally, FFR may be estimated with techniques such as computational fluid dynamics. Certain limitations should be considered in the interpretation of this study.

Quantitative Coronary and Left Ventricular Cineangiography: Methodology and Clinical Applications

First, hospitals participating in the study represented a select group of tertiary care facilities, so we may have underestimated the magnitude of misinterpretation had less sophisticated hospitals been included. Second, owing to the small number of physicians in each hospital, we were unable to assess the between-physician variation in a hospital. Third, this is a pragmatic study of actual practice and we do not have details on how they produced their estimates of lesion severity. Finally, we did not evaluate cases where PCI was not performed and were unable to assess when angiographically severe stenoses were underappreciated.

In this large study of patients undergoing contemporary PCI in China, we found that PVA significantly overestimated coronary stenosis severity compared with independent measurements by QCA, supporting the need for greater use of functional assessments prior to the performance of PCI. Large variations across hospitals and among physicians suggest that efforts are urgently needed to improve the accuracy of interpretations of coronary angiograms and to optimize the selection of patients for PCI in current clinical practice.

Published Online: January 16, Author Contributions: Dr Jiang had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Drs Zhang and Mu contributed equally to the study. Drs Krumholz and Jiang contributed equally to the study and are joint senior authors.

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Li, X. Li, Zheng, Y. Li, Krumholz. Li, Zheng, Krumholz, Jiang. Li, Zheng. Cohen receives research grant support from Medtronic, Boston Scientific, and Abbott Vascular, and consulting fees from Medtronic. No other disclosures are reported.

Cardiovascular magnetic resonance phase contrast imaging

Chan School of Public Health. We are grateful for the support provided by the Chinese government. All Rights Reserved. Figure 1. View Large Download.

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Table 1. Between-laboratory comparison of quantitative coronary angiography eTable 2. J Am Coll Cardiol. PubMed Google Scholar Crossref. Putting ad hoc PCI on pause. Effect of variability in the interpretation of coronary angiograms on the appropriateness of use of coronary revascularization procedures.

Am Heart J. Interobserver variability in coronary angiography. Interoperator and intraoperator in accuracy of stent selection based on visual estimation. Catheter Cardiovasc Interv. Comparison of clinical interpretation with visual assessment and quantitative coronary angiography in patients undergoing percutaneous coronary intervention in contemporary practice: the Assessing Angiography A2 Project.

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Quantitative coronary angiography in the current era: principles and applications. J Interv Cardiol. Revascularization decisions in patients with stable angina and intermediate lesions: results of the international survey on interventional strategy. Circ Cardiovasc Interv. Clinical outcomes of fractional flow reserve by computed tomographic angiography-guided diagnostic strategies vs. Eur Heart J. The china patient-centered evaluative assessment of cardiac events PEACE prospective study of percutaneous coronary intervention: study design. Assessment of short-, medium-, and long-term variations in arterial dimensions from computer-assisted quantitation of coronary cineangiograms.