Author/Authors :
Cannon، نويسنده , , Christopher P. and Brindis، نويسنده , , Ralph G. and Chaitman، نويسنده , , Bernard R. and Cohen، نويسنده , , David J. and Cross Jr، نويسنده , , J. Thomas and Drozda Jr، نويسنده , , Joseph P. and Fesmire، نويسنده , , Francis M. and Fintel، نويسنده , , Dan J. and Fonarow، نويسنده , , Gregg C. and Fox، نويسنده , , Keith A. and Gray، نويسنده , , Darryl T. and Harrington، نويسنده , , Robert A. and Hicks، نويسنده , , Karen A. and Hollander، نويسنده , , Judd E. and Krumholz، نويسنده , , Harlan and Labarthe، نويسنده , , Darwin R. and Long، نويسنده , , Janet B. and Mascette، نويسنده , , Alice M. and Meyer، نويسنده , , Connie and Peterson، نويسنده , , Eric D. and Radford، نويسنده , , Martha J. and Roe، نويسنده , , Matthew T. and Richmann، نويسنده , , James B. and Selker، نويسنده , , Harry P. and Shahian، نويسنده , , David M. and Shaw، نويسنده , , Richard E. and Sprenger، نويسنده , , Sharon and Swor، نويسنده , , Robert and Underberg، نويسنده , , James A. and Van de Werf، نويسنده , , Frans and Weiner، نويسنده , , Bonnie H. and Weintraub، نويسنده , , William S.، نويسنده ,
Abstract :
Objectives
(Fractional Flow Reserve and Intravascular Ultrasound Relationship Study) aimed to determine the optimal minimum lumen area (MLA) by intravascular ultrasound (IVUS) that correlates with fractional flow reserve (FFR) and to assess the correlation between virtual histology IVUS and FFR for intermediate coronary lesions.
ound
considered the gold standard for assessing intermediate coronary lesions. Measurements of ≤0.8 are considered clinically significant and indicative of physiological ischemia.
s
is a multicenter, prospective, international registry of patients with intermediate coronary lesions, defined as 40% to 80% stenosis by angiography. In total, 350 patients (367 lesions) were enrolled at 10 U.S. and European sites. Patients were followed through hospital discharge.
s
l, an MLA <3.07 mm2 (64.0% sensitivity, 64.9% specificity, area under curve [AUC] = 0.65) was the best threshold value for identifying FFR <0.8. The accuracy improved when reference vessel–specific analyses were performed. An MLA <2.4 mm2 (AUC = 0.66) was best for reference vessel diameters <3.0 mm, an MLA <2.7 mm2 (AUC = 0.71) for reference vessel diameters of 3.0 to 3.5 mm, and an MLA <3.6 mm2 (AUC = 0.68) for reference vessel diameters >3.5 mm. FFR correlated with plaque burden (r = −0.220, p < 0.001) but not with other plaque morphology.
sions
ic measurements by IVUS show a moderate correlation with the FFR values. The optimal cutoff for an MLA to FFR <0.8 is vessel dependent. Plaque morphology characteristics do not correlate with FFR. The utility of IVUS MLA as an alternative to FFR to guide intervention in intermediate lesions may be limited in accuracy and should be tested clinically. (Fractional Flow Reserve and Intravascular Ultrasound Relationship Study [FIRST]; NCT01153555)
