Correlation Between Quantitative Angiography-Derived Translesional Pressure and Fractional Flow Reserve

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• 作者：Fumiyasu Seike ; MD^a ; ^{seike.fumiyasu.fx@ehime-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Teruyoshi Uetani ; MD^a ; Kazuhisa Nishimura ; MD^a ; Chiharuko Iio ; MD^a ; Hiroshi Kawakami ; MD^a ; Kaori Fujimoto ; MD^a ; Haruhiko Higashi ; MD^a ; Tamami Kono ; MD^a ; Jun Aono ; MD^a ; Takayuki Nagai ; MD^a ; Katsuji Inoue ; MD^a ; Jun Suzuki ; MD^a ; Akiyoshi Ogimoto ; MD^a ; Takafumi Okura ; MD^a ; Kazunori Yasuda ; PhD^b ; Jitsuo Higaki ; MD^a ; Shuntaro Ikeda ; MD^a
• 刊名：The American Journal of Cardiology
• 出版年：2016
• 出版时间：15 October 2016
• 年：2016
• 卷：118
• 期：8
• 页码：1158-1163
• 全文大小：901 K

文摘

Fractional flow reserve (FFR) is widely used for the assessment of myocardial ischemia. However, it has the disadvantage of cost and invasive complication risks. We investigated the usefulness of quantitative coronary angiography–derived translesional pressure (QCA-TP) for predicting functional myocardial ischemia, using FFR as the gold standard. We retrospectively analyzed 152 coronary narrowings (98 left anterior descending arteries, 28 left circumflex arteries, and 26 right) in 132 patients with mild-severe coronary stenosis who underwent coronary angiography and FFR measurements simultaneously. QCA-TP was calculated using software implemented in the QCA software. Coronary morphology was calculated using both densitometry and lumen edges. Functional myocardial ischemia was defined as an FFR of 0.8 or less. The mean values of diameter stenosis by QCA and FFR were 48.9% ± 14.9 and 0.76 ± 0.14, respectively. QCA-TP was significantly correlated with FFR (r = 0.76, p <0.01). The cut-off values of QCA-TP for predicting functional myocardial ischemia based on FFR were 72.8 mm Hg for the left anterior descending arteries (accuracy, 86.7%; area under the curve [AUC], 0.93), 60.5 mm Hg for the left circumflex arteries (accuracy, 89.3%; AUC, 0.88), and 64.4 mm Hg for the right (accuracy, 88.5%; AUC, 0.94). Therefore, our data suggest that QCA-TP can predict myocardial ischemia with high diagnostic accuracy.