Influence of plaque characteristics on fractional flow reserve for coronary lesions with intermediate to obstructive stenosis: insights from integrated-backscatter intravascular ultrasound analysis
Autor: | Masahiko Gosho, Akiyoshi Kurita, Katsuhisa Waseda, Masanobu Fujimoto, Akihiro Suzuki, Shinichiro Sakurai, Hiroaki Takashima, Kazuyuki Maeda, Tetsuya Amano, Hirohiko Ando |
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Rok vydání: | 2015 |
Předmět: |
Male
medicine.medical_specialty Coronary Artery Disease Fractional flow reserve Coronary Angiography Severity of Illness Index Coronary artery disease Predictive Value of Tests Internal medicine Bayesian multivariate linear regression Image Interpretation Computer-Assisted Intravascular ultrasound medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Ultrasonography Interventional Cardiac imaging Aged medicine.diagnostic_test Unstable angina business.industry Coronary Stenosis Models Cardiovascular Mean Aortic Pressure Middle Aged medicine.disease Coronary Vessels Plaque Atherosclerotic Fractional Flow Reserve Myocardial Predictive value of tests cardiovascular system Cardiology Female Radiology Cardiology and Cardiovascular Medicine business |
Zdroj: | The International Journal of Cardiovascular Imaging. 31:1295-1301 |
ISSN: | 1573-0743 1569-5794 |
DOI: | 10.1007/s10554-015-0699-6 |
Popis: | The aim of this study was to determine the correlation between the fractional flow reserve (FFR) values and volumetric intravascular ultrasound (IVUS) parameters derived from classic gray-scale IVUS and integrated backscatter (IB)-IVUS, taking into account known confounding factors. Patients with unstable angina pectoris with the frequent development of vulnerable plaques often showed the discrepancy between the FFR value and the quantitative coronary angiography findings. Our target population was 107 consecutive subjects with 114 isolated lesions who were scheduled for elective coronary angiography. The FFR was calculated as the mean distal coronary pressure divided by the mean aortic pressure during maximal hyperemia. Various volumetric parameters such as lipid plaque volume (LPV) and percentage of LPV (%LPV) were measured using IB-IVUS. Simple and multivariate linear regression analysis was employed to evaluate the correlation between FFR values and various classic gray-scale IVUS and IB-IVUS parameters. The Akaike information criterion (AIC) was used to compare the goodness of fit in an each model. Both the %LPV (r = -0.24; p = 0.01) and LPV (r = -0.40; p < 0.01) were significantly correlated with the FFR value. Only the LPV (AIC = -147.0; p = 0.006) and %LPV (AIC = -152.9; p = 0.005) proved to be independent predictors for the FFR value even after the adjustment of known confounding factors. The volumetric assessment by IB-IVUS could provide better information in terms of the relationship between plaque morphology and the FFR values as compared to the classic IVUS 2-dimensional gray-scale analysis. |
Databáze: | OpenAIRE |
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