Relationship Between Intravascular Ultrasound Parameters and Fractional Flow Reserve in Intermediate Coronary Artery Stenosis of Left Anterior Descending Artery: Intravascular Ultrasound Volumetric Analysis

被引:36
作者
Yang, Hyoung-Mo [1 ]
Tahk, Seung-Jea [1 ]
Lim, Hong-Seok [1 ]
Yoon, Myeong-Ho [1 ]
Choi, So-Yeon [1 ]
Choi, Byoung-Joo [1 ]
Jin, Xiong Jie [1 ]
Hwang, Gyo-Seung [1 ]
Park, Jin-Sun [1 ]
Shin, Joon-Han [1 ]
机构
[1] Ajou Univ, Sch Med, Dept Cardiol, Suwon 443721, South Korea
关键词
intravascular ultrasound; fractional flow reserve; plaque volume; FUNCTIONAL-SIGNIFICANCE; ANGIOGRAPHY; CRITERIA;
D O I
10.1002/ccd.25088
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
ObjectivesThe objective of this study was to assess the relationship between intravascular ultrasound (IVUS) parameters, including volumetric analysis, and fractional flow reserve (FFR). BackgroundAlthough it is known that coronary atherosclerosis burden measured by IVUS volumetric analysis is related with clinical outcomes, its relationship with functional significance remains unknown. MethodsBoth IVUS and FFR were performed in 206 cases of intermediate stenosis of the left anterior descending artery (LAD). Myocardial ischemia was assessed by FFR and maximal hyperemia was induced by continuous intracoronary adenosine infusion. FFR<0.80 was considered as significant inducible myocardial ischemia. We performed standard IVUS parameter measurements and volumetric analyses. IVUS parameter comparison was performed in the presence (n=90) or absence (n =116) of significant myocardial ischemia. ResultsLesions with minimal lumen area (MLA)4.0 mm(2) had FFR0.80 in 91.4% of cases, while 50.9% of lesions with MLA<4.0 mm(2) had FFR<0.80. The independent predictors of FFR<0.80 were IVUS lesion length (odds ratio [OR]: 1.1, 95% confidence interval [CI]=1.06-1.18, P<0.001) and MLA significance according to the lesion location (OR: 7.01, 95% CI=3.09-15.92, P=0.001). FFR correlated with plaque volume (r=-0.345, P<0.001) and percent atheroma volume (PAV) (r=-0.398, P<0.001). Lesions with significant ischemia (FFR<0.80) as compared to those with FFR>0.80 were associated with larger plaque volume (181.882.3 vs. 125.9 +/- 77.9 mm(3), P<0.001) and PAV (58.9 +/- 5.6 vs. 53.8 +/- 7.9%, P<0.001). ConclusionsIVUS parameters representing severity and extent of atheromatous plaque correlated with functional significance in LAD lesions with intermediate stenosis. (c) 2013 Wiley Periodicals, Inc.
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页码:386 / 394
页数:9
相关论文
共 18 条
[1]   Clinical, intravascular ultrasound, and quantitative angiographic determinants of the coronary flow reserve before and after percutaneous transluminal coronary angioplasty [J].
Abizaid, A ;
Mintz, GS ;
Pichard, AD ;
Kent, KM ;
Satler, LF ;
Walsh, CL ;
Popma, JJ ;
Leon, MB .
AMERICAN JOURNAL OF CARDIOLOGY, 1998, 82 (04) :423-428
[2]   Long-term follow-up after percutaneous transluminal coronary angioplasty was not performed based on intravascular ultrasound findings - Importance of lumen dimensions [J].
Abizaid, AS ;
Mintz, GS ;
Mehran, R ;
Abizaid, A ;
Lansky, AJ ;
Pichard, AD ;
Satler, LF ;
Wu, HS ;
Pappas, C ;
Kent, KM ;
Leon, MB .
CIRCULATION, 1999, 100 (03) :256-261
[3]  
Austen W G, 1975, Circulation, V51, P5
[4]   Correlation between fractional flow reserve and intravascular ultrasound lumen area in intermediate coronary artery stenosis [J].
Ben-Dor, Itsik ;
Torguson, Rebecca ;
Gaglia, Michael A., Jr. ;
Gonzalez, Manuel A. ;
Maluenda, Gabriel ;
Bui, Anh B. ;
Xue, Zhenyi ;
Satler, Lowell F. ;
Suddath, William O. ;
Lindsay, Joseph ;
Pichard, Augusto D. ;
Waksman, Ron .
EUROINTERVENTION, 2011, 7 (02) :225-233
[5]   Intravascular ultrasound criteria for the assessment of the functional significance of intermediate coronary artery stenoses and comparison with fractional glow reserve [J].
Briguori, C ;
Anzuini, A ;
Airoldi, F ;
Gimelli, G ;
Nishida, T ;
Adamian, M ;
Corvaja, N ;
Di Mario, C ;
Colombo, A .
AMERICAN JOURNAL OF CARDIOLOGY, 2001, 87 (02) :136-141
[6]   Intravascular ultrasound assessment of drug-eluting stent expansion [J].
Costa, Jose de Ribamar, Jr. ;
Mintz, Gary S. ;
Carlier, Stephane G. ;
Fujii, Kenichi ;
Sano, Koichi ;
Kimura, Masashi ;
Tanaka, Kaoru ;
Costa, Ricardo A. ;
Lui, Joanna ;
Na, Yingbo ;
Castellanos, Celia ;
Biro, Sinan ;
Moussa, Issam ;
Stone, Gregg W. ;
Moses, Jeffrey W. ;
Leon, Martin B. .
AMERICAN HEART JOURNAL, 2007, 153 (02) :297-303
[7]   Anatomical and physiologic assessments in patients with small coronary artery disease: Final results of the Physiologic and Anatomical Evaluation Prior to and After Stent Implantation in Small Coronary Vessels (PHANTOM) trial [J].
Costa, Marco A. ;
Sabate, Manel ;
Staico, Rodolfo ;
Alfonso, Fernando ;
Seixas, Ana C. ;
Albertal, Mariano ;
Crossman, Arthur ;
Angiolillo, Dominick J. ;
Zenni, Martin ;
Sousa, J. Eduardo ;
Macaya, Carlos ;
Bass, Theodore A. .
AMERICAN HEART JOURNAL, 2007, 153 (02) :296.e1-296.e7
[8]   PRESSURE-FLOW CHARACTERISTICS OF CORONARY STENOSES IN UNSEDATED DOGS AT REST AND DURING CORONARY VASODILATION [J].
GOULD, KL .
CIRCULATION RESEARCH, 1978, 43 (02) :242-253
[9]   Validation of Intravascular Ultrasound-Derived Parameters With Fractional Flow Reserve for Assessment of Coronary Stenosis Severity [J].
Kang, Soo-Jin ;
Lee, Jong-Young ;
Ahn, Jung-Min ;
Mintz, Gary S. ;
Kim, Won-Jang ;
Park, Duk-Woo ;
Yun, Sung-Cheol ;
Lee, Seung-Whan ;
Kim, Young-Hak ;
Lee, Cheol Whan ;
Park, Seong-Wook ;
Park, Seung-Jung .
CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2011, 4 (01) :65-71
[10]   Plaque volume derived from three-dimensional reconstruction of coronary angiography predicts the fractional flow reserve [J].
Kolozsvari, R. ;
Tar, B. ;
Lugosi, P. ;
Santa, J. ;
Beres, Z. ;
Ungvari, T. ;
Polgar, P. ;
Koszegi, Zs. .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2012, 160 (02) :140-144