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The Relationship between Stenosis Severity and Ischemia

Podcast discussion of the value of CT angiography to measure stenosis severity and predict ischemia.

In this podcast from the American Society of Nuclear Cardiology (full title: “Assessment of the Relationship between Stenosis Severity and Distribution of Coronary Artery Stenoses on Multislice Computed Tomographic Angiography and Myocardial Ischemia Detected by Single Photon Emission Computed Tomography”), Balaji Tamarappoo, MD, a cardiologist at Cedars-Sinai Medical Center, discusses “the relationship between luminal stenosis measured by coronary CT angiography and severity of stress-induced ischemia.”

The podcast is based on an article that was published in the Journal of Nuclear Cardiology. The authors of the article sought to evaluate the relationship between stenosis severity assessed by coronary CT angiography (CCTA) and ischemia on single-photon emission computed tomographic myocardial perfusion imaging (SPECT-MPI). They reported that the positive predictive value of CCTA for ischemia by SPECT-MPI rises as stenosis severity increases. Specifically, they concluded that “luminal stenosis ≥90% on CCTA strongly predicts ischemia, while <50% stenosis strongly predicts the absence of ischemia. Serial stenosis of ≥50% in a vessel may offer incremental value in addition to stenosis severity in predicting ischemia.”

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