Prediction of Fractional Flow Reserve without Hyperemic Induction Based on Resting Baseline Pd/Pa.
10.4070/kcj.2013.43.5.309
- Author:
Jeong Su KIM
1
;
Heon Deok LEE
;
Yong Kweon SUH
;
June Hong KIM
;
Kook Jin CHUN
;
Yong Hyun PARK
;
Jun KIM
;
Dong Cheul HAN
;
Chang Bae SOHN
Author Information
1. Division of Cardiology, Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea. junehongk@gmail.com
- Publication Type:Original Article
- Keywords:
Cardiovascular physiological phenomana;
Fractional flow reserve, myocardial
- MeSH:
Coronary Vessels;
Fractional Flow Reserve, Myocardial;
Glycosaminoglycans;
Hyperemia;
Sensitivity and Specificity
- From:Korean Circulation Journal
2013;43(5):309-315
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: The purposes of this study are 1) to investigate the relationship between resting baseline Pd/Pa, determined by the ratio of the pressures proximal (Pa) and distal (Pd) to the target lesion before, inducing hyperemia and fractional flow reserve (FFR) and 2) to identify a resting baseline Pd/Pa range that might reliably preclude the need for hyperemic induction. SUBJECTS AND METHODS: A total of 622 pressure wire data sets obtained from intermediate stenotic lesions were analyzed. RESULTS: There was a good linear relationship between resting baseline Pd/Pa and FFR (r=0.746, p<0.001). Receiver-operating characteristic curves of the resting baseline Pd/Pa with FFR < or =0.80 as the reference variable showed an area under the curve of 0.89 (95% confidence intervals 0.863-0.914, p<0.001) with a diagnostic accuracy of 82.3% when the resting baseline Pd/Pa was < or =0.92. These results showed that certain cutoff values can reliably predict FFR, whether positive or negative. The resting baseline Pd/Pa >0.95 (n=257, 41.3%) had a negative predictive value (NPV) of 98.1% and a sensitivity of 97.3%. the resting baseline Pd/Pa < or =0.88 (n=65, 10.5%) had a positive predictive value (PPV) of 96.2% and a specificity of 99.8%. These were consistent regardless of coronary vessel, lesion location, lesion length, or degree of stenosis. CONCLUSION: In intermediate lesions, the resting baseline Pd/Pa was linearly related to FFR. A certain range of the resting baseline Pd/Pa values had an excellent NPV with high sensitivity or excellent PPV with high specificity for determining the lesion significance.
