Correlation Between Intracoronary Doppler and Sesta MIBI Measurements in the Assessment of Angiographic Intermediate Coronary Artery Stenosis

Intermediate coronary artery stenosis (ICAS) (30-70 percent luminal stenosis) are special group of lesions of whom physiologic importance is hard to assess. Two different methods were used in order to evaluate the significance of ICAS and the correlation between the methods were sought. Intracoronary Doppler measurements were done after standard coronary angiography in 20 patients of whom 14 had left anterior descenting artery (LAD), 5 had right coronary artery (RCA) and 1 had intermediate artery lesions. Ratio of the proximal and distal mean velocities of the ICAS and coronary flow reserve (CFR) were measured after intracoronary papaverin injection. The patients' mean age was 54 ± 6 years and 17 of them were men and 3 were women. Intracoronary injection of 3 mCi Tc-99m Sestamibi was performed in basal conditions and SPECT images were held after 3.5±0.7 hours. If the ratio was smaller than 1.7 and CFR smaller than 2, the ICAS was considered as significant. In the evaluation of SPECT images, when the ratio of the counts obtained from the lesion territory to that obtained from the normal one was smaller than 75 % the ICAS was considered as significant. Pearson correlation analysis and kappa test were performed between dichotomous variables. Correlation and kappa test results between methods were and found as follows: Ratio (0.51, 0.44), Stenosis-CFR (-0.52, 0.32), Stenosis-MIBI (-0.48,0.17), Ratio-CFR (-0.79,0.86), Ratio-MIBI (-0,13,0.44), CFR-MIBI (0.44,0.55). The correlation between Ratio-CFR and kappa test between CFR-MIBI are statistically significant (p<0.001 and p<0.01, respectively). The most powerful correlation was found between Ratio and CFR, and the weakest one was between Ratio and MIBI. The correlation and kappa value between the most predictive criteria of two methods, CFR and MIBI, were in medium strength and good, respectively.