Prevalence of visual–functional mismatch regarding coronary artery stenosis in the CVIT-DEFER registry

被引：48

作者：

Nakamura M. ^{[1
]}

Yamagishi M. ^{[2
]}

Ueno T. ^{[3
]}

Hara K. ^{[4
]}

Ishiwata S. ^{[5
]}

Itoh T. ^{[6
]}

Hamanaka I. ^{[7
]}

Wakatsuki T. ^{[8
]}

Sugano T. ^{[9
]}

Kawai K. ^{[10
]}

Akasaka T. ^{[11
]}

Tanaka N. ^{[12
]}

Kimura T. ^{[13
]}

机构：

[1] Division of Cardiovascular Medicine, Ohashi Medical Center, Toho University School of Medicine, 2-17-6 Ohashi, Meguro-ku, Tokyo

[2] Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa

[3] Center of Cardiovascular Medicine, Kurume University Hospital, Kurume

[4] Division of Internal Medicine, Mitsui Memorial Hospital, Tokyo

[5] Division of Cardiology, Cardiovascular Center, Toranomon Hospital, Tokyo

[6] Division of Cardiology, Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Morioka

[7] Rakuwakai Kyoto Cardiovascular Intervention Center, Rakuwakai Marutamachi Hospital, Kyoto

[8] Department of Cardiovascular Medicine, Institute of Health Biosciences, University of Tokushima, Tokushima

[9] Department of Cardiology, Yokohama City University Hospital, Yokohama

[10] Department of Cardiovascular Medicine, Chikamori Hospital, Kochi

[11] Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama

[12] Department of Cardiology, Tokyo Medical University, Tokyo

[13] Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto

来源：

Cardiovascular Intervention and Therapeutics | 2014年 / 29卷 / 4期

关键词：

Angiographic coronary stenosis; FFR; Functional coronary stenosis;

D O I：

10.1007/s12928-014-0259-3

中图分类号：

学科分类号：

摘要：

The fractional flow reserve (FFR) is considered to be a reliable index for the assessment of clinically relevant coronary artery stenosis. However, mismatch in assessing the severity of coronary stenosis between coronary angiography and the FFR has been pointed out. The cardiovascular intervention therapeutics (CVIT)-DEFER registry is a prospective multicenter registry study that has enrolled 3,228 consecutive patients among 3,804 patients with angiographically moderate coronary artery lesions in whom FFR analysis was clinically indicated. The demographic and angiographic parameters associated with an FFR ≤0.8 were analyzed, and the incidence of discrepancy between the angiographic severity of coronary stenosis and the FFR was assessed. Based on the visual assessment, 1,609 (42.9 %) lesions were categorized as showing 50 % stenosis, 1,882 lesions (50.2 %) as 75 % stenosis, and 257 lesions (6.9 %) as 90 % stenosis. Angiographic–FFR “mismatch,” which was defined as visual stenosis ≥75 % with FFR >0.80, was found in 43.4 % of lesions, while reverse angiographic mismatch (visual stenosis <75 % with FFR ≤0.8) was found in 23.2 %. The independent predictors for “angiographic–FFR mismatch” were the presence of percutaneous coronary intervention (PCI) history, one-vessel disease, non-left anterior descending artery (LAD) location, non-diffuse lesion, non-ostial lesion, and non-tandem lesion. Conversely, “reverse angiographic mismatch” was independently associated with the multivessel disease, LAD location, and diffuse lesion. The FFR is not only influenced by luminal stenosis but also by coronary artery morphology and the amount of jeopardized myocardium. Angiographic–FFR mismatch is frequent in patients with moderate coronary stenosis, which suggests the clinical importance of using physiological assessment to guide PCI. © 2014, Japanese Association of Cardiovascular Intervention and Therapeutics.

引用

页码：300 / 308

页数：8

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