• Gould, K L, (PI)

Project: Research projectResearch Project


The severity of coronary stenosis can be analyzed anatomically and
functionally. Anatomic severity is measured in geometric terms by
quantitative arteriography. Functional severity is determined by directly
measured coronary flow, pressure gradient and coronary flow reserve. In
theory, anatomic and functional approaches to quantifying stenosis severity
should be interchangeable, mathematically and experimentally equivalent
since they are derived from common fluid dynamic principles. To document
this equivalency, the Specific Aims are to test the following hypothesis:
(1) Coronary flow reserve (CFR) of a stenotic coronary artery can be
accounted for or predicted by arteriography from all the geometric
dimensions of a stenosis-length, relative % narrowing, absolute diameter
under measured or controlled conditions of aortic pressure, coronary
vasoconstrictor tone or significant collateral flow. (2) Failure to
account for one or more dimensions of a stenosis causes significant errors
in the x-ray prediction of CFR even where there may be a correlation
between CFR and a given single dimension. (3) Collateral circulation
sufficient to provide normal resting flow does not cause a significant
error in the x-ray prediction of CFR due to low flow capacity of
collaterals. (4) Coronary flow reserve is accurately predicted from all
stenosis dimensions over a wide range of coronary vasoconstrictor tone.
(5) Neither flexible wall collapse of stenoses, changing flow velocity
profiles nor entrance effects cause significant errors in x-ray prediction
of CFR. This study will demonstrate that coronary flow reserve measured
directly or predicted by quantitative coronary arteriography is a single
measure of stenosis severity accounting for all its geometric
characteristics and will establish the relation between functional and
anatomic descriptors of stenosis severity suitable for routine clinical
Effective start/end date7/1/8212/31/89


  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health


Pathologic Constriction
Coronary Stenosis
Vasoconstrictor Agents
Coronary Vessels
Arterial Pressure


  • Medicine(all)