Document Detail


Diastolic fractional flow reserve to assess the functional severity of moderate coronary artery stenoses: comparison with fractional flow reserve and coronary flow velocity reserve.
MedLine Citation:
PMID:  11067790     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Coronary blood flow occurs mainly during the diastolic phase of each cardiac cycle and is mainly dependent on diastolic driving pressure, especially in the left anterior descending coronary artery (LAD). We hypothesized that calculation of the ratio of the diastolic driving pressure of a stenotic LAD to its normal value, namely diastolic FFR (d-FFR), might provide precise insight into the mechanism of FFR for assessment of the functional severity of the stenosis. We compared d-FFR with FFR, coronary flow reserve (CFR), and exercise myocardial thallium scintigraphy in an lesion of intermediate severity. METHODS AND RESULTS: The study population consisted of 46 consecutive patients with a moderate stenosis in the LAD in whom simultaneous measurements of aortic pressure, left ventricular pressure, and coronary pressure distal to the stenosis were obtained. Coronary flow velocity was successfully measured with a Doppler guidewire in 37 of the 46 patients. Values for FFR, d-FFR, and CFR in the noninvasive test-positive group were significantly lower than those in the negative group. With cutoff values of 0.75, 0.76, and 2.0 for FFR, d-FFR, and CFR, sensitivities were 83.3%, 95.8%, and 88.2% and specificities were 100%, 100%, and 95.0%, respectively. CONCLUSIONS: The close similarity of the sensitivity and specificity of FFR and d-FFR, around almost identical cutoff values (0.75 versus 0.76), confirms the physiological validity of FFR as a clinical standard. In clinical practice, FFR remains the index of choice for assessment of the functional severity of moderate coronary artery stenoses.
Authors:
M Abe; H Tomiyama; H Yoshida; N Doba
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  102     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-11-13     Completed Date:  2000-11-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2365-70     Citation Subset:  IM    
Affiliation:
Cardiovascular Center, Division of Cardiology, Third Department of Internal Medicine, Teikyo University School of Medicine, Ichihara Hospital, Ichihara, Chiba, Japan. cao02110@pop02.odn.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Blood Flow Velocity
Coronary Circulation / physiology*
Coronary Disease / diagnosis*,  physiopathology
Diastole / physiology*
Humans
Laser-Doppler Flowmetry
Severity of Illness Index

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