Nobuhisa Hagiwara
   Department   Other, Other
   Position  
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),pp.120-126
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
Authorship Last author
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