| Correlations between fractional flow reserve and intravascular ultrasound in patients with an ambiguous left main coronary artery stenosis. | |
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MedLine Citation:
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PMID: 15492302 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Intravascular ultrasound (IVUS) is being used to assess the significance of a left main coronary artery stenosis (LMCS). However, the cutoff values of IVUS parameters at which to predict a fractional flow reserve (FFR) of 0.75 are unknown. METHODS AND RESULTS: In 55 patients with an angiographically ambiguous LMCS, a pressure guidewire was used to calculate FFR, and IVUS parameters were calculated after automatic pullback. FFR averaged 0.86+/-0.13 (range, 0.55 to 1.0). IVUS minimum lumen diameter (MLD), minimum lumen area (MLA), cross-sectional narrowing (CSN), and area stenosis (AS) were 3.8+/-0.61 mm, 7.65+/-2.9 mm2, 59+/-13%, and 47+/-19%, respectively. Regression analysis demonstrated strong correlations between FFR and MLD (r=0.79, P<0.0001) as well as between FFR and MLA (r=0.74, P<0.0001). There were inverse, moderate correlations between FFR and CSN (r=0.69, P<0.0001), followed by those between FFR and AS (r=0.54, P<0.0001). Compared with FFR as the "gold standard," an MLD of 2.8 mm had the highest sensitivity and specificity (93% and 98%, respectively) for determining the significance of an LMCS, followed by an MLA of 5.9 mm2 (93% and 95%, respectively). Based on an FFR <0.75 and an FFR > or =0.75, the 38-month survival and event-free survival estimates (EFSEs) were both 100% and 100% versus 90%, respectively (P=NS). CONCLUSIONS: We conclude that (1) an IVUS MLD and MLA of 2.8 mm and 5.9 mm2, respectively, strongly predict the physiological significance of an LMCS and (2) among patients with an LMCS, an FFR of 0.75 is a strong predictor of survival and EFSE. |
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Authors:
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Venu Jasti; Eugen Ivan; Venkata Yalamanchili; Nattawut Wongpraparut; Massoud A Leesar |
Publication Detail:
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Type: Journal Article Date: 2004-10-18 |
Journal Detail:
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Title: Circulation Volume: 110 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2004 Nov |
Date Detail:
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Created Date: 2004-11-02 Completed Date: 2005-09-30 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 2831-6 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology, University of Louisville, Louisville, KY 40292, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine
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diagnostic use Aged Angioplasty, Transluminal, Percutaneous Coronary / statistics & numerical data Cardiovascular Diseases / mortality Coronary Angiography Coronary Artery Bypass / statistics & numerical data Coronary Stenosis / physiopathology, ultrasonography* Disease Progression Disease-Free Survival Female Follow-Up Studies Heart Catheterization Hemodynamics* Humans Hyperemia / chemically induced, physiopathology Life Tables Male Middle Aged Myocardial Infarction / epidemiology Pressure Single-Blind Method Transducers, Pressure Ultrasonography, Interventional* |
| Chemical | |
Reg. No./Substance:
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58-61-7/Adenosine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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