[Reliability of digital coronary quantification in a hemodynamic laboratory. Comparison with a film-based system].
OBJECTIVE
Quantitative coronary angiography can be performed in two ways: on-line during catheterism, and off-line once the procedure is finished. Consequently, several studies have been published comparing both systems. Nevertheless, none of them has compared the measurements made off-line with those acquired on-line by the hemodynamist in charge of procedure. The objective of this study was to compare the measurements made on-line by the hemodynamist involved in the procedure with a digital system (DCI) with those obtained off-line by an independent and alien observer to the procedure by using film-based system (CMS).


METHODS
Forty coronary lesions suitable for quantification were measured in a prospective fashion. They came from follow-up angiograms. Either balloon or stent were used in the previous angioplasty. Stenoses were assessed on-line and off-line by using the most severe view as judged by the hemodynamist.


RESULTS
No significant differences were found for obstruction diameter, reference diameter nor percent diameter stenosis. Pearson's correlation coefficient values (r), intraclass correlation coefficient (ri), regression line equation and mean of signed differences with their standard deviations are showed: a) obstruction diameter: r = 0.83, ri = 0.83, DCI = 0.42 + 0.76 x CMS, -0.01 +/- 0.42 mm; b) reference diameter: r = 0.72, ri = 0.69, DCI = 1.29 + 0.61 x CMS, 0.003 +/- 0.38 mm, y c) percent diameter stenosis: r = 0.86, ri = 0.86, DCI = 10.05 + 0.77 x CMS, 1.19 +/- 10.75%.


CONCLUSIONS
We attained good concordance between both quantification systems under clinical conditions. In our opinion these results support the use of on-line quantification as a reliable tool for clinical decision making in the catheterization laboratory.
Serrano Sánchez
J A
JA
Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid. jaserrano@jet.es
García Robles
J A
JA
García Fernández
E J
EJ
Delcán Domínguez
J L
JL
D017023:Coronary Angiography / Q000295:instrumentation*; D003331:Coronary Vessels / Q000473:pathology*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D015203:Reproducibility of Results
Fiabilidad de la cuantificación coronaria digital realizada en el laboratorio de hemodinámica. Comparación con un sistema basado en película.