0090: Comparison between non-invasive coronary flow reserve, instantaneous wave-free ratio, and fractional flow reserve, to assess the functional significance of LAD stenosis of intermediate severity

Autor: Jacques Boulanger, Patrick Meimoun, Hamdane Zemir, Anne Luycx-Bore, Jerome Clerc, F. Elmkies, Sonia Martis, Dorothée Ardourel
Rok vydání: 2016
Předmět:
Zdroj: Archives of Cardiovascular Diseases Supplements. 8(1)
ISSN: 1878-6480
DOI: 10.1016/s1878-6480(16)30030-1
Popis: IntroductionAssessment of the functional significance of left anterior descending coronary artery (LAD) stenosis of intermediate severity (IS) is challenging. A direct comparison of fractional flow reserve (FFR), instantaneous wave-free ratio (IFR), and non-invasive coronary flow reserve (CFR) has never been performed. Our objective was to test the usefulness of noninvasive CFR by comparison to invasive FFR and IFR in patients with LAD stenosis of angiographic IS and stable coronary artery disease.Methods58 stable consecutive patients (mean age, 68±10 years; with angiographic proximal or mid LAD stenosis of IS (40-70% diameter stenosis on quantitative coronary angiography), no previous anterior myocardial infarction, were prospectively studied. They underwent iFR which was calculated as a trans-lesion pressure ratio during a specific period of baseline diastole, FFR with intracoronary bolus adenosine (150μg), and CFR using intravenous adenosine (140μg/kg/min over 2min) in the distal part of the LAD, the same day. CFR was defined as hyperemic peak diastolic LAD flow velocity divided by baseline flow velocity, and FFR was defined as distal pressure divided by mean aortic pressure during maximal hyperemia.ResultsThe mean values of iFR, FFR, and CFR were 0.88±0.07, 0.81±0.08, and 2.4±0.6 respectively. A significant correlation was found between CFR and FFR (r=0.72, curvilinear relationship), FFR and IFR (r=0.63, linear relationship), and between CFR and IFR (r=0.44) (all, p
Databáze: OpenAIRE
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