Optimal Intravascular Ultrasound Criteria for Defining the Functional Significance of Intermediate Coronary Stenosis: An International Multicenter Study

被引：23

作者：

Han, Jung-Kyu ^{[1
]}

Koo, Bon-Kwon ^{[1
]}

Park, Kyung-Woo ^{[1
]}

Ben-Dor, Itsik ^{[12
]}

Waksman, Ron ^{[12
]}

Pichard, Augusto ^{[12
]}

Nam, Chang-Wook ^{[3
]}

Doh, Joon-Hyung ^{[4
]}

Murata, Naotaka ^{[6
]}

Tanaka, Nobuhiro ^{[6
]}

Lee, Chi-Hang ^{[8
]}

Gonzalo, Nieves ^{[9
]}

Escaned, Javier ^{[9
]}

Costa, Marco A. ^{[11
]}

Kubo, Takashi ^{[7
]}

Akasaka, Takashi ^{[7
]}

Hu, Xinyang ^{[10
]}

Wang, JianAn ^{[10
]}

Yang, Hyoung-Mo ^{[5
]}

Yoon, Myung-Ho ^{[5
]}

Tahk, Seung-Jea ^{[5
]}

Ma, Seunghyun ^{[2
]}

Park, Sue K. ^{[2
]}

Kim, Hyo-Soo ^{[1
]}

机构：

[1] Seoul Natl Univ Hosp, Seoul 110744, South Korea

[2] Seoul Natl Univ, Coll Med, Seoul, South Korea

[3] Keimyung Univ, Dongsan Med Ctr, Taegu, South Korea

[4] Inje Univ, Ilasn Hosp, Goyang, South Korea

[5] Ajou Univ Hosp, Suwon, South Korea

[6] Tokyo Med Univ Hosp, Tokyo, Japan

[7] Wakayama Med Univ, Wakayama, Japan

[8] Natl Univ Singapore Hosp, Singapore 117548, Singapore

[9] Hosp Clin San Carlos, Madrid, Spain

[10] Zhejiang Univ, Affiliated Hosp 2, Hangzhou 310003, Zhejiang, Peoples R China

[11] Univ Hosp Cleveland, Cleveland, OH 44106 USA

[12] Washington Hosp Ctr, Washington, DC 20010 USA

来源：

CARDIOLOGY | 2014年 / 127卷 / 04期

关键词：

Fractional flow reserve; Intravascular ultrasound; Minimal lumen area; Ethnicity; FRACTIONAL FLOW RESERVE; ARTERY STENOSES; ANGIOPLASTY;

D O I：

10.1159/000356480

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: We aimed to assess the ideal cut-off value of minimal lumen area (MLA) by intravascular ultrasound (IVUS) and its diagnostic performance to predict ischemia, using a large-scale, pooled analysis. Methods: Eleven centers worldwide were invited to provide their clinical, IVUS and fractional flow reserve (FFR) data. A total of 881 lesions were enrolled. Results: Angiographic % diameter stenosis (r = -0.373, p < 0.0001) and IVUS MLA (r = 0.289, p < 0.0001) correlated with FFR. Best cut-off value (BCV) of IVUS MLA to define the functional significance (FFR <0.8) was 2.75 mm(2) (AUC 0.646, 95% Cl 0.609-0.684). When the diagnostic performance of IVUS MLA was tested according to the lesion location, BCV could be found only in lesions in the proximal artery and the mid-left anterior descending artery. Interestingly, Asians (n = 623) and Westerners (n = 258) showed different demographic and lesion characteristics as well as different BCVs to define ischemia. The BCV for the proximal/mid-left anterior descending artery lesions was 2.75 mm(2) (AUC 0.688, 95% Cl 0.635-0.742) in Asians and 3.0 mm(2) (AUC 0.695, 95% Cl 0.605-0.786) in Westerners. Conclusion: In this pooled analysis, an IVUS MLA of 2.75 mm(2) was the BCV to define the functional significance of intermediate coronary stenosis. However, when IVUS MLA is used to determine the functional significance, both the lesion and patient characteristics should be considered. (C) 2014 S. Karger AG, Basel

引用

页码：256 / 262

页数：7

共 17 条

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