Document Detail


Resting Pd/Pa measured with intracoronary pressure wire strongly predicts fractional flow reserve.
MedLine Citation:
PMID:  20516504     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the relationship between resting distal coronary pressure to aortic pressure ratio (Pd/Pa) and fractional flow reserve (FFR) obtained during maximal hyperemia. BACKGROUND: FFR is an invasive index of the functional severity of a coronary artery stenosis determined from coronary pressure measurements. It is generally believed that there is little correlation between resting Pd/Pa and FFR obtained during maximal hyperemia. We have therefore studied this relationship in a large cohort of patients who had undergone pressure- wire assessments. METHODS: 528 consecutive pressure-wire studies performed in 483 patients over a 2-year period were retrospectively analyzed. RESULTS: A linear correlation between resting Pd/Pa and FFR post-pharmacological hyperemia was observed (rho = 0.74; p < 0.0001). When a FFR of < or = 0.75 (or < or = 0.80 as per FAME) was defined as positive, a resting Pd/Pa of < or = 0.85 (< or = 0.87) had a positive predictive value (PPV) of 95% (94.6%), while a resting Pd/Pa of > or = 0.93 (> or = 0.96) had a negative predictive value (NPV) of 95.7% (93%). CONCLUSIONS: We demonstrate a strong correlation between resting Pd/Pa and FFR. Resting values of Pd/Pa can be used to predict a positive FFR result with relatively high PPV and NPV. This may potentially obviate the need for adenosine infusion in a proportion of pressure-wire studies.
Authors:
Mamas A Mamas; Simon Horner; Elise Welch; Anthony Ashworth; Simon Millington; Doug Fraser; Farzin Fath-Ordoubadi; Ludwig Neyses; Magdi El-Omar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  22     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-02     Completed Date:  2010-09-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  260-5     Citation Subset:  IM    
Affiliation:
Manchester Heart Centre, Manchester Royal Infirmary, Biomedical Research Centre, Manchester, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / diagnosis,  physiopathology
Adenosine / diagnostic use
Aorta / physiology
Blood Pressure / physiology*
Cohort Studies
Coronary Circulation / physiology*
Coronary Stenosis / diagnosis*,  physiopathology*
Coronary Vessels / physiology
Female
Heart Catheterization / instrumentation,  methods*
Humans
Hyperemia / diagnosis,  physiopathology
Male
Middle Aged
Predictive Value of Tests
ROC Curve
Retrospective Studies
Severity of Illness Index
Vasodilator Agents / diagnostic use
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 58-61-7/Adenosine

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