HIROSHI OGAWA
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Lesion characteristics of coronary arteries associated with a mismatch between angiographic severity of stenosis and fractional flow reserve.
Journal Formal name:Cardiovascular intervention and therapeutics
Abbreviation:Cardiovasc Interv Ther
ISSN code:18684300/18684297
Domestic / ForeginDomestic
Publisher Springer Japan
Volume, Issue, Page 32(2),120-126頁
Author and coauthor ARASHI Hiroyuki†, YAMAGUCHI Junichi*, NAKAZAWA Mayui, OOTSUKI Hisao, HARUKI Shintaro, NAKAO Masashi, KAMISHIMA Kazuho, JUJO Kentaro, MINAMI Yuichiro, TAKAGI Atsushi, OGAWA Hiroshi, HAGIWARA Nobuhisa
Publication date 2017/04
Summary We aimed to clarify the relationships between angiographic lesion characteristics and values of fractional flow reserve (FFR) on intermediate coronary artery stenosis. The clinical meaning and assessment for "visual-functional mismatches," including regular-mismatches [defined as angiographic percent diameter stenosis (%DS) ≥50 % and FFR >0.80] and reverse-mismatches (defined as angiographic %DS <50 %, FFR ≤0.80) remains unresolved in contemporary practice. We retrospectively enrolled 140 consecutive patients who underwent coronary angiography and FFR measurement. One hundred fifty-seven cases of intermediate coronary artery stenosis were evaluated. The relationship between clinical/lesion characteristics and regular- or reverse-mismatches were examined. Lesions in the left anterior descending artery (LAD) showed significantly lower frequency of regular-mismatch than did non-LAD lesions (26.7 vs. 73.3 %, respectively; p < 0.001). Conversely, almost all reverse-mismatches were observed in LAD lesions (93.8 %). The best cut-off value of %DS, derived from receiver operating characteristic (ROC) curve analysis, to predict FFR ≤0.8 was 45.0 % in LAD lesions and 67.5 % in non-LAD lesions. FFR measurement should be considered in LAD intermediate lesions to avoid residual functional ischemia and in non-LAD lesions to avoid unnecessary coronary intervention.
DOI 10.1007/s12928-016-0399-8
PMID 27236812