(Circulation. 1995;92:2333-2342.)
© 1995 American Heart Association, Inc.
Articles |
Our Preoccupation With Coronary Luminology
The Dissociation Between Clinical and Angiographic Findings in Ischemic Heart Disease
From the Department of Cardiology and the Joseph J. Jacobs Center for Thrombosis and Vascular Biology, Cleveland Clinic Foundation, Cleveland, Ohio.
Correspondence to Eric J. Topol, MD, Department of Cardiology, Cleveland Clinic Foundation, 9500 Euclid Ave, Desk F25, Cleveland, Ohio 44195. E-mail internettopole@ccsmtp.ccf.org.
Abstract Nearly 40 years after its invention, the angiogram is still considered by most physicians to be the "gold standard" for defining coronary anatomy. Careful investigations have revealed many deficiencies inherent in this approach. The purpose of this article is to outline the evidence that our current preoccupation with coronary "luminology" may be misguided and to propose a rational paradigm for future practice and investigation. Angiography depicts coronary anatomy from a planar two-dimensional silhouette of the lumen. Angiography is limited in resolution to four or five line pairs per millimeter. Confounding factors include vessel tortuosity, overlap of structures, and the effects of lumen shape. After intervention, a hazy, broadened silhouette may overestimate the actual gain in lumen size. Studies show marked disparity between the apparent severity of lesions and their physiological effects. After myocardial infarction, cardiologists too often do not make an attempt to demonstrate the physiological significance of the stenosis before performing percutaneous coronary revascularization. Similarly, the allure of a better, more gratifying angiogram with new interventional devices appears to be a dominant factor in their popularity. Interventional cardiologists should be aware that techniques yielding marked angiographic benefit may also generate important but unrecognized hazards. The dissociation between the angiogram and clinical outcome should influence future research efforts. Our review of the literature indicates that we may benefit from shifting the current focus and preoccupation with coronary luminology to achieving the desired clinical end point: promoting survival and long-term freedom from myocardial infarction and the disabling symptoms of coronary heart disease.
Key Words: angiography • myocardial infarction • atherosclerosis • revascularization • angioplasty
This article has been cited by other articles:
 |
|
 |
|
  H BRODOEFEL, C BURGSTAHLER, M HEUSCHMID, A REIMANN, F KHOSA, A KOPP, S SCHROEDER, C D CLAUSSEN, and M E CLOUSE Accuracy of dual-source CT in the characterisation of non-calcified plaque: use of a colour-coded analysis compared with virtual histology intravascular ultrasound Br. J. Radiol., October 1, 2009; 82(982): 805 - 812. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Gaemperli, L. Husmann, T. Schepis, P. Koepfli, I. Valenta, W. Jenni, H. Alkadhi, T. F. Luscher, and P. A. Kaufmann Coronary CT angiography and myocardial perfusion imaging to detect flow-limiting stenoses: a potential gatekeeper for coronary revascularization? Eur. Heart J., August 14, 2009; (2009) ehp304v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L HUSMANN, O GAEMPERLI, I VALENTA, T SCHEPIS, H SCHEFFEL, P STOLZMANN, S LESCHKA, L DESBIOLLES, B MARINCEK, H ALKADHI, et al. Impact of vessel attenuation on quantitative coronary angiography with 64-slice CT Br. J. Radiol., August 1, 2009; 82(980): 649 - 653. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Rassi Jr Prognostic Utility of Coronary Computed Tomography Angiography: Are We Looking at the Correct Outcomes and Making Appropriate Comparisons? J. Am. Coll. Cardiol. Img., July 1, 2009; 2(7): 914 - 914. [Full Text] [PDF]
|
|
|
|
 |
|
 F. Hyafil, J.-C. Cornily, J. H.F. Rudd, J. Machac, L. J. Feldman, and Z. A. Fayad Quantification of Inflammation Within Rabbit Atherosclerotic Plaques Using the Macrophage-Specific CT Contrast Agent N1177: A Comparison with 18F-FDG PET/CT and Histology J. Nucl. Med., June 1, 2009; 50(6): 959 - 965. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. C. McCulloch, S. Paulin, S. K. Gerard, G. Karthikeyan, G. Vorobiof, W. M. Fogarty Jr., J. A.C. Lima, J. M. Miller, the CORE 64 Investigators, J. Walsh, et al. Coronary Angiography by 64-Row CT N. Engl. J. Med., May 7, 2009; 360(19): 2027 - 2031. [Full Text] [PDF]
|
|
|
|
|
|
M. J. Lipinski, J. C. Frias, V. Amirbekian, K. C. Briley-Saebo, V. Mani, D. Samber, A. Abbate, J. G. S. Aguinaldo, D. Massey, V. Fuster, et al. Macrophage-Specific Lipid-Based Nanoparticles Improve Cardiac Magnetic Resonance Detection and Characterization of Human Atherosclerosis. J. Am. Coll. Cardiol. Img., May 1, 2009; 2(5): 637 - 647. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. C. Hendel Is Computed Tomography Coronary Angiography the Most Accurate and Effective Noninvasive Imaging Tool to Evaluate Patients With Acute Chest Pain in the Emergency Department?: CT Coronary Angiography Is the Most Accurate and Effective Noninvasive Imaging Tool for Evaluating Patients Presenting With Chest Pain to the Emergency Department: Antagonist Viewpoint Circ Cardiovasc Imaging, May 1, 2009; 2(3): 264 - 275. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Ramcharitar, F. Pugliese, C. Schultz, J. Ligthart, P. de Feyter, H. Li, N. Mollet, M. van de Ent, P. W. Serruys, and R. J. van Geuns Integration of multislice computed tomography with magnetic navigation facilitates percutaneous coronary interventions without additional contrast agents. J. Am. Coll. Cardiol., March 3, 2009; 53(9): 741 - 746. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. Eagle and H. S. Gurm We Were Fishing for TROUT and We Caught a CARP: Musings on Perioperative Management in an Age of Enlightenment Circ Cardiovasc Qual Outcomes, March 1, 2009; 2(2): 61 - 62. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Brodoefel, C. Burgstahler, A. Sabir, C.-S. Yam, F. Khosa, C. D. Claussen, and M. E. Clouse Coronary Plaque Quantification by Voxel Analysis: Dual-Source MDCT Angiography Versus Intravascular Sonography Am. J. Roentgenol., March 1, 2009; 192(3): W84 - W89. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A.L. Tonino, B. De Bruyne, N. H.J. Pijls, U. Siebert, F. Ikeno, M. van `t Veer, V. Klauss, G. Manoharan, T. Engstrom, K. G. Oldroyd, et al. Fractional Flow Reserve versus Angiography for Guiding Percutaneous Coronary Intervention N. Engl. J. Med., January 15, 2009; 360(3): 213 - 224. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S. Lauer CT Angiography: First Things First Circ Cardiovasc Imaging, January 1, 2009; 2(1): 1 - 3. [Full Text] [PDF]
|
|
|
|
 |
|
 T. Pratap, J. A. Sloand, and C. R. Narins Potential Pitfalls of Renal Angiography: A Case of Atypical Fibromuscular Dysplasia Angiology, January 1, 2009; 59(6): 753 - 756. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Meimoun, T. Benali, F. Elmkies, S. Sayah, A. Luycx-Bore, L. Doutrelan, Z. Hamdane, J. Boulanger, and C. Tribouilloy Prognostic value of transthoracic coronary flow reserve in medically treated patients with proximal left anterior descending artery stenosis of intermediate severity Eur J Echocardiogr, January 1, 2009; 10(1): 127 - 132. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. E. Nissen Limitations of computed tomography coronary angiography. J. Am. Coll. Cardiol., December 16, 2008; 52(25): 2145 - 2147. [Full Text] [PDF]
|
|
|
|
 |
|
 F.L. Lucas, A.E. Siewers, D.J. Malenka, and D.E. Wennberg Diagnostic-Therapeutic Cascade Revisited: Coronary Angiography, Coronary Artery Bypass Graft Surgery, and Percutaneous Coronary Intervention in the Modern Era Circulation, December 16, 2008; 118(25): 2797 - 2802. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Gibbons Noninvasive Diagnosis and Prognosis Assessment in Chronic Coronary Artery Disease: Stress Testing With and Without Imaging Perspective Circ Cardiovasc Imaging, November 1, 2008; 1(3): 257 - 269. [Full Text] [PDF]
|
|
|
|
|
|
M. J. Kern Limitations of Angiographic Predictors of Bypass Graft Patency J. Am. Coll. Cardiol., September 2, 2008; 52(10): 886 - 887. [Full Text] [PDF]
|
|
|
|
 |
|
 O. Gaemperli, T. Schepis, I. Valenta, P. Koepfli, L. Husmann, H. Scheffel, S. Leschka, F. R. Eberli, T. F. Luscher, H. Alkadhi, et al. Functionally Relevant Coronary Artery Disease: Comparison of 64-Section CT Angiography with Myocardial Perfusion SPECT Radiology, August 1, 2008; 248(2): 414 - 423. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Meimoun and C. Tribouilloy Non-invasive assessment of coronary flow and coronary flow reserve by transthoracic Doppler echocardiography: a magic tool for the real world Eur J Echocardiogr, July 1, 2008; 9(4): 449 - 457. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. Clouse, A. Sabir, C.-S. Yam, N. Yoshimura, S. Lin, F. Welty, P. Martinez-Clark, and V. Raptopoulos Measuring Noncalcified Coronary Atherosclerotic Plaque Using Voxel Analysis with MDCT Angiography: A Pilot Clinical Study Am. J. Roentgenol., June 1, 2008; 190(6): 1553 - 1560. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Ballantyne, J. S. Raichlen, S. J. Nicholls, R. Erbel, J.-C. Tardif, S. J. Brener, V. A. Cain, S. E. Nissen, and for the ASTEROID Investigators Effect of Rosuvastatin Therapy on Coronary Artery Stenoses Assessed by Quantitative Coronary Angiography: A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden Circulation, May 13, 2008; 117(19): 2458 - 2466. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J.P. Kastelein and E. de Groot Ultrasound imaging techniques for the evaluation of cardiovascular therapies Eur. Heart J., April 1, 2008; 29(7): 849 - 858. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Larson, K. M. Menssen, S. W. Sharkey, S. Duval, R. S. Schwartz, J. Harris, J. T. Meland, B. T. Unger, and T. D. Henry "False-Positive" Cardiac Catheterization Laboratory Activation Among Patients With Suspected ST-Segment Elevation Myocardial Infarction JAMA, December 19, 2007; 298(23): 2754 - 2760. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Ebeling Barbier, T. Bjerner, T. Hansen, J. Andersson, L. Lind, J. Hulthe, L. Johansson, and H. Ahlstrom Clinically Unrecognized Myocardial Infarction Detected at MR Imaging May Not Be Associated with Atherosclerosis Radiology, October 1, 2007; 245(1): 103 - 110. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. A. Lin, R. A. Dudley, and R. F. Redberg Cardiologists' Use of Percutaneous Coronary Interventions for Stable Coronary Artery Disease Arch Intern Med, August 13, 2007; 167(15): 1604 - 1609. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A.G. Van Mieghem, A. Thury, W. B. Meijboom, F. Cademartiri, N. R. Mollet, A. C. Weustink, G. Sianos, P. P.T. de Jaegere, P. W. Serruys, and P. de Feyter Detection and characterization of coronary bifurcation lesions with 64-slice computed tomography coronary angiography Eur. Heart J., August 2, 2007; 28(16): 1968 - 1976. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Raggi and A. Bellasi Review: Imaging to assess effect of medical therapy in patients with diabetes mellitus The British Journal of Diabetes & Vascular Disease, July 1, 2007; 7(4): 157 - 164. [Abstract] [PDF]
|
|
|
|
|
|
M. E. Merhige, W. J. Breen, V. Shelton, T. Houston, B. J. D'Arcy, and A. F. Perna Impact of Myocardial Perfusion Imaging with PET and 82Rb on Downstream Invasive Procedure Utilization, Costs, and Outcomes in Coronary Disease Management J. Nucl. Med., July 1, 2007; 48(7): 1069 - 1076. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Rispler, Z. Keidar, E. Ghersin, A. Roguin, A. Soil, R. Dragu, D. Litmanovich, A. Frenkel, D. Aronson, A. Engel, et al. Integrated Single-Photon Emission Computed Tomography and Computed Tomography Coronary Angiography for the Assessment of Hemodynamically Significant Coronary Artery Lesions J. Am. Coll. Cardiol., March 13, 2007; 49(10): 1059 - 1067. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Lee, C. Shirodaria, C. E Jackson, M. D Robson, C. Antoniades, J. M Francis, F. Wiesmann, K. M Channon, S. Neubauer, and R. P Choudhury Multi-modal magnetic resonance imaging quantifies atherosclerosis and vascular dysfunction in patients with type 2 diabetes mellitus Diabetes and Vascular Disease Research, March 1, 2007; 4(1): 44 - 48. [Abstract] [PDF]
|
|
|
|
|
|
A. S. Jaffe, L. Babuin, and F. S. Apple Reply J. Am. Coll. Cardiol., November 8, 2006; (2006) j.jacc.2006.10.012v1. [Full Text] [PDF]
|
|
|
|
|
|
P. Kligfield and M. S. Lauer Exercise Electrocardiogram Testing: Beyond the ST Segment Circulation, November 7, 2006; 114(19): 2070 - 2082. [Full Text] [PDF]
|
|
|
|
|
|
M. J. Kern, A. Lerman, J.-W. Bech, B. De Bruyne, E. Eeckhout, W. F. Fearon, S. T. Higano, M. J. Lim, M. Meuwissen, J. J. Piek, et al. Physiological Assessment of Coronary Artery Disease in the Cardiac Catheterization Laboratory: A Scientific Statement From the American Heart Association Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology Circulation, September 19, 2006; 114(12): 1321 - 1341. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Bugiardini, O. Manfrini, and G. M. De Ferrari Unanswered questions for management of acute coronary syndrome: risk stratification of patients with minimal disease or normal findings on coronary angiography. Arch Intern Med, July 10, 2006; 166(13): 1391 - 1395. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. S. Jaffe, L. Babuin, and F. S. Apple Biomarkers in Acute Cardiac Disease: The Present and the Future J. Am. Coll. Cardiol., July 4, 2006; 48(1): 1 - 11. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Nicholls, E. M. Tuzcu, T. Crowe, I. Sipahi, P. Schoenhagen, S. Kapadia, S. L. Hazen, C.-C. Wun, M. Norton, F. Ntanios, et al. Relationship Between Cardiovascular Risk Factors and Atherosclerotic Disease Burden Measured by Intravascular Ultrasound J. Am. Coll. Cardiol., May 16, 2006; 47(10): 1967 - 1975. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Whittle, N. R. Kressin, E. D. Peterson, M. B. Orner, M. Glickman, M. Mazzella, and L. A. Petersen Racial Differences in Prevalence of Coronary Obstructions Among Men With Positive Nuclear Imaging Studies J. Am. Coll. Cardiol., May 16, 2006; 47(10): 2034 - 2041. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. W. Stone and H. D. Aronow Long-term Care After Percutaneous Coronary Intervention: Focus on the Role of Antiplatelet Therapy Mayo Clin. Proc., May 1, 2006; 81(5): 641 - 652. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Nicholls, E. M. Tuzcu, I. Sipahi, P. Schoenhagen, T. Crowe, S. Kapadia, and S. E. Nissen Relationship Between Atheroma Regression and Change in Lumen Size After Infusion of Apolipoprotein A-I Milano J. Am. Coll. Cardiol., March 7, 2006; 47(5): 992 - 997. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Escolar, G. Weigold, A. Fuisz, and N. J. Weissman New imaging techniques for diagnosing coronary artery disease. Can. Med. Assoc. J., February 14, 2006; 174(4): 487 - 495. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. R. Albers, M. Z. Krichavsky, and G. J. Balady Stress Testing in Patients With Diabetes Mellitus: Diagnostic and Prognostic Value Circulation, January 31, 2006; 113(4): 583 - 592. [Full Text] [PDF]
|
|
|
|
 |
|
 F. Hyafil, J.-P. Laissy, M. Mazighi, D. Tchetche, L. Louedec, H. Adle-Biassette, S. Chillon, D. Henin, M.-P. Jacob, D. Letourneur, et al. Ferumoxtran-10-Enhanced MRI of the Hypercholesterolemic Rabbit Aorta: Relationship Between Signal Loss and Macrophage Infiltration Arterioscler Thromb Vasc Biol, January 1, 2006; 26(1): 176 - 181. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Legalery, F. Schiele, M.-F. Seronde, N. Meneveau, H. Wei, K. Didier, M.-C. Blonde, F. Caulfield, and J.-P. Bassand One-year outcome of patients submitted to routine fractional flow reserve assessment to determine the need for angioplasty Eur. Heart J., December 2, 2005; 26(24): 2623 - 2629. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. H. K. Hoffmann Coronary Angiography With Multislice Computed Tomography--Reply JAMA, November 9, 2005; 294(18): 2298 - 2299. [Full Text] [PDF]
|
|
|
|
 |
|
 J. J. Nawarskas and L. A. Osborn Paclitaxel-eluting stents in coronary artery disease Am. J. Health Syst. Pharm., November 1, 2005; 62(21): 2241 - 2251. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. J. Topol The Genomic Basis of Myocardial Infarction J. Am. Coll. Cardiol., October 18, 2005; 46(8): 1456 - 1465. [Full Text] [PDF]
|
|
|
|
|
|
P. A. Grayburn Stress Echo Without the Stress: Detection of Coronary Stenosis at Rest by Myocardial Contrast Echocardiography Circulation, August 23, 2005; 112(8): 1085 - 1087. [Full Text] [PDF]
|
|
|
|
|
|
M. Lauer, E. S. Froelicher, M. Williams, and P. Kligfield Exercise Testing in Asymptomatic Adults: A Statement for Professionals From the American Heart Association Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention Circulation, August 2, 2005; 112(5): 771 - 776. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Kaufmann, M. Namdar, F. Matthew, M. Roffi, S. V. Aschkenasy, B. van der Loo, G. Sutsch, T. F. Luscher, and R. Jenni Novel Doppler Assessment of Intracoronary Volumetric Flow Reserve: Validation Against PET in Patients With or Without Flow-Dependent Vasodilation J. Nucl. Med., August 1, 2005; 46(8): 1272 - 1277. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Namdar, T. F. Hany, P. Koepfli, P. T. Siegrist, C. Burger, C. A. Wyss, T. F. Luscher, G. K. von Schulthess, and P. A. Kaufmann Integrated PET/CT for the Assessment of Coronary Artery Disease: A Feasibility Study J. Nucl. Med., June 1, 2005; 46(6): 930 - 935. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. L. Moens, I. Goovaerts, M. J. Claeys, and C. J. Vrints Flow-Mediated Vasodilation: A Diagnostic Instrument, or an Experimental Tool? Chest, June 1, 2005; 127(6): 2254 - 2263. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Lindstaedt, M. K. Fritz, A. Yazar, C. Perrey, A. Germing, P. H. Grewe, A. M. Laczkovics, A. Mugge, and W. Bojara Optimizing revascularization strategies in patients with multivessel coronary disease: Impact of intracoronary pressure measurements J. Thorac. Cardiovasc. Surg., April 1, 2005; 129(4): 897 - 903. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.-A. Fassa, K. Wagatsuma, S. T. Higano, V. Mathew, G. W. Barsness, R. J. Lennon, D. R. Holmes Jr, and A. Lerman Intravascular ultrasound-guided treatment for angiographically indeterminate left main coronary artery disease: A long-term follow-up study J. Am. Coll. Cardiol., January 18, 2005; 45(2): 204 - 211. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. P. Salm, J. J. Bax, H. W. Vliegen, S. E. Langerak, P. Dibbets, J. W. Jukema, H. J. Lamb, E. K.J. Pauwels, A. de Roos, and E. E. van der Wall Functional significance of stenoses in coronary artery bypass grafts: Evaluation by single-photon emission computed tomography perfusion imaging, cardiovascular magnetic resonance, and angiography J. Am. Coll. Cardiol., November 2, 2004; 44(9): 1877 - 1882. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Voci, F. Pizzuto, and F. Romeo Coronary flow: a new asset for the echo lab? Eur. Heart J., November 1, 2004; 25(21): 1867 - 1879. [Full Text] [PDF]
|
|
|
|
|
|
J. Shemesh, N. Koren-Morag, S. Apter, J. Rozenman, B. A. Kirwan, Y. Itzchak, and M. Motro Accelerated Progression of Coronary Calcification: Four-year Follow-up in Patients with Stable Coronary Artery Disease Radiology, October 1, 2004; 233(1): 201 - 209. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Clark, A. Bakhai, M. J. Lacey, E. M. Pelletier, and D. J. Cohen Clinical and Economic Outcomes of Percutaneous Coronary Interventions in the Elderly: An Analysis of Medicare Claims Data Circulation, July 20, 2004; 110(3): 259 - 264. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Schoenhagen, S. S. Halliburton, A. E. Stillman, S. A. Kuzmiak, S. E. Nissen, E. M. Tuzcu, and R. D. White Noninvasive Imaging of Coronary Arteries: Current and Future Role of Multi-Detector Row CT Radiology, July 1, 2004; 232(1): 7 - 17. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. J. Schoepf, C. R. Becker, B. M. Ohnesorge, and E. K. Yucel CT of Coronary Artery Disease Radiology, July 1, 2004; 232(1): 18 - 37. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Horiguchi, H. Yamamoto, Y. Akiyama, K. Marukawa, N. Hirai, and K. Ito Coronary Artery Calcium Scoring Using 16-MDCT and a Retrospective ECG-Gating Reconstruction Algorithm Am. J. Roentgenol., July 1, 2004; 183(1): 103 - 108. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Orford, A. Lerman, and D. R. Holmes Routine intravascular ultrasound guidance of percutaneous coronary intervention: A critical reappraisal J. Am. Coll. Cardiol., April 21, 2004; 43(8): 1335 - 1342. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. E. Nissen, E. M. Tuzcu, P. Schoenhagen, B. G. Brown, P. Ganz, R. A. Vogel, T. Crowe, G. Howard, C. J. Cooper, B. Brodie, et al. Effect of Intensive Compared With Moderate Lipid-Lowering Therapy on Progression of Coronary Atherosclerosis: A Randomized Controlled Trial JAMA, March 3, 2004; 291(9): 1071 - 1080. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Fathi, B. Haluska, N. Isbel, L. Short, and T. H. Marwick The relative importance of vascular structure and function in predicting cardiovascular events J. Am. Coll. Cardiol., February 18, 2004; 43(4): 616 - 623. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. E. Nissen, T. Tsunoda, E. M. Tuzcu, P. Schoenhagen, C. J. Cooper, M. Yasin, G. M. Eaton, M. A. Lauer, W. S. Sheldon, C. L. Grines, et al. Effect of Recombinant ApoA-I Milano on Coronary Atherosclerosis in Patients With Acute Coronary Syndromes: A Randomized Controlled Trial JAMA, November 5, 2003; 290(17): 2292 - 2300. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. M. Tuzcu and P. Schoenhagen Acute coronary syndromes, plaque vulnerability,and carotid artery disease: The changing role ofatherosclerosis imaging J. Am. Coll. Cardiol., September 17, 2003; 42(6): 1033 - 1036. [Full Text] [PDF]
|
|
|
|
|
|
D. P. Vivekananthan, E. H. Blackstone, C. E. Pothier, and M. S. Lauer Heart rate recovery after exercise is apredictor of mortality, independent of the angiographic severity of coronary disease J. Am. Coll. Cardiol., September 3, 2003; 42(5): 831 - 838. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ruscazio, R. Montisci, and S. Iliceto Expanding the noninvasive coronary physiology assessment with transthoracic Doppler echocardiography Eur J Echocardiogr, September 1, 2003; 4(3): 159 - 161. [Full Text] [PDF]
|
|
|
|
 |
|
 A L Gaster, U Slothuus Skjoldborg, J Larsen, L Korsholm, C von Birgelen, S Jensen, P Thayssen, K E Pedersen, and T H Haghfelt Continued improvement of clinical outcome and cost effectiveness following intravascular ultrasound guided PCI: insights from a prospective, randomised study Heart, September 1, 2003; 89(9): 1043 - 1049. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K.-H. Mak and D. P. Faxon Clinical studies on coronary revascularization in patients with type 2 diabetes Eur. Heart J., June 2, 2003; 24(12): 1087 - 1103. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Brophy, P. Belisle, and L. Joseph Evidence for Use of Coronary Stents: A Hierarchical Bayesian Meta-Analysis Ann Intern Med, May 20, 2003; 138(10): 777 - 786. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Leesar, T. Abdul-Baki, N. I. Akkus, A. Sharma, T. Kannan, and R. Bolli Use of fractional flow reserve versus stress perfusion scintigraphy after unstable angina: Effect on duration of hospitalization, cost, procedural characteristics, and clinical outcome J. Am. Coll. Cardiol., April 2, 2003; 41(7): 1115 - 1121. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. G. McKay "Ischemia-guided" versus "early invasive" strategies in the management of acute coronary syndrome/non-ST-segment elevation myocardial infarction: The interventionalist's perspective J. Am. Coll. Cardiol., February 19, 2003; 41(4_Suppl_S): 96S - 102S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. E. Nissen Pathobiology, not angiography, should guide managementin acute coronary syndrome/non-ST-segment elevation myocardial infarction: The non-interventionist's perspective J. Am. Coll. Cardiol., February 19, 2003; 41(4_Suppl_S): 103S - 112S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. E. Cutlip, M. S. Chauhan, D. S. Baim, K. K. L. Ho, J. J. Popma, J. P. Carrozza, D. J. Cohen, and R. E. Kuntz Clinical restenosis after coronary stenting: perspectives from multicenter clinical trials J. Am. Coll. Cardiol., December 18, 2002; 40(12): 2082 - 2089. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. DeFranco Understanding the pathophysiology of the arterial wall: which method should we choose? Intra-vascular ultrasound Eur. Heart J. Suppl., September 1, 2002; 4(suppl_F): F29 - F40. [Abstract] [PDF]
|
|
|
|
|
|
D. Brosh, S. T. Higano, M. J. Slepian, H. I. Miller, M. J. Kern, R. J. Lennon, D. R. Holmes Jr, and A. Lerman Pulse transmission coefficient: a novel nonhyperemic parameter for assessing the physiological significance of coronary artery stenoses J. Am. Coll. Cardiol., March 20, 2002; 39(6): 1012 - 1019. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. J. Chamuleau, R. A. Tio, C. C. de Cock, E. D. de Muinck, N. H. J. Pijls, B. L. F. van Eck-Smit, K. T. Koch, M. Meuwissen, M. G. W. Dijkgraaf, A. de Jong, et al. Prognostic value of coronary blood flow velocity and myocardial perfusion in intermediate coronary narrowings and multivessel disease J. Am. Coll. Cardiol., March 6, 2002; 39(5): 852 - 858. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C.L. de Korte, S.G. Carlier, F. Mastik, M.M. Doyley, A.F.W. van der Steen, P.W. Serruys, and N. Bom Morphological and mechanical information of coronary arteries obtained with intravascular elastography. Feasibility study in vivo Eur. Heart J., March 1, 2002; 23(5): 405 - 413. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F Chirillo, A Bruni, G Balestra, C Cavallini, Z Olivari, J D Thomas, and P Stritoni Assessment of internal mammary artery and saphenous vein graft patency and flow reserve using transthoracic Doppler echocardiography Heart, October 1, 2001; 86(4): 424 - 431. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Mudra, C. di Mario, P. de Jaegere, H. R. Figulla, C. Macaya, R. Zahn, B. Wennerblom, W. Rutsch, V. Voudris, E. Regar, et al. Randomized Comparison of Coronary Stent Implantation Under Ultrasound or Angiographic Guidance to Reduce Stent Restenosis (OPTICUS Study) Circulation, September 18, 2001; 104(12): 1343 - 1349. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. A. Fayad and V. Fuster Clinical Imaging of the High-Risk or Vulnerable Atherosclerotic Plaque Circ. Res., August 17, 2001; 89(4): 305 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Cohen, M. Doucet, D. E. Cutlip, K. K.L. Ho, J. J. Popma, and R. E. Kuntz Impact of Smoking on Clinical and Angiographic Restenosis After Percutaneous Coronary Intervention: Another Smoker's Paradox? Circulation, August 14, 2001; 104(7): 773 - 778. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. C. Keelan, L. F. Bielak, K. Ashai, L. S. Jamjoum, A. E. Denktas, J. A. Rumberger, P. F. Sheedy, II, P. A. Peyser, and R. S. Schwartz Long-Term Prognostic Value of Coronary Calcification Detected by Electron-Beam Computed Tomography in Patients Undergoing Coronary Angiography Circulation, July 24, 2001; 104(4): 412 - 417. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. R. deFilippi, S. Rosanio, M. Tocchi, R. J. Parmar, M. A. Potter, B. F. Uretsky, and M. S. Runge Randomized comparison of a strategy of predischarge coronary angiography versus exercise testing in low-risk patients in a chest pain unit: in-hospital and long-term outcomes J. Am. Coll. Cardiol., June 15, 2001; 37(8): 2042 - 2049. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. E. Newby, A. L. McLeod, N. G. Uren, L. Flint, C. A. Ludlam, D. J. Webb, K. A. A. Fox, and N. A. Boon Impaired Coronary Tissue Plasminogen Activator Release Is Associated With Coronary Atherosclerosis and Cigarette Smoking : Direct Link Between Endothelial Dysfunction and Atherothrombosis Circulation, April 17, 2001; 103(15): 1936 - 1941. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. S. Mintz, S. E. Nissen, W. D. Anderson, S. R. Bailey, R. Erbel, P. J. Fitzgerald, F. J. Pinto, K. Rosenfield, R. J. Siegel, E. M. Tuzcu, et al. American College of Cardiology clinical expert consensus document on standards for acquisition, measurement and reporting of intravascular ultrasound studies (ivus): A report of the american college of cardiology task force on clinical expert consensus documents developed in collaboration with the european society of cardiology endorsed by the society of cardiac angiography and interventions J. Am. Coll. Cardiol., April 1, 2001; 37(5): 1478 - 1492. [Full Text] [PDF]
|
|