TY - JOUR
T1 - Coronary pressure measurement to assess the hemodynamic significance of serial stenoses within one coronary-artery : validation in humans
AU - Pijls, N.H.J.
AU - Bruyne, de, B. (Bernard)
AU - Bech, G.J.W.
AU - Liistro, F.
AU - Heyndrickx, G.R.
AU - Bonnier, J.J.R.M.
AU - Koolen, J.J. (Jacques)
PY - 2000
Y1 - 2000
N2 - Background—When several stenoses are present within 1 coronary artery, the hemodynamic significance of each stenosis is influenced by the presence of the other(s), and the calculation of coronary and fractional flow reserve (CFR and FFR) for each individual stenosis is confounded. Recently, we developed and experimentally validated a method to determine the true FFR of each stenosis as it would be after the removal of the other stenosis; the true FFR can be reliably predicted by coronary pressures measured before treatment at specific locations within the coronary artery using equations accounting for stenosis interaction. The aim of the present study was to test the validity of these equations in humans.
Methods and Results—In this study of 32 patients with 2 serial stenoses in 1 coronary artery, relevant pressures were measured before the intervention, after the treatment of 1 stenosis, and after the treatment of both stenoses. The true FFR of each stenosis (FFRtrue) was directly measured after the elimination of the other stenosis and compared with the value predicted (FFRpred) from the initial pressure measurements before treatment. Although the hyperemic gradient across 1 stenosis increased significantly (from 10±7 to 19±11 mm Hg after treatment of the other stenosis), FFRpred was close to FFRtrue in all patients (0.78±0.12 versus 0.78±0.11 mm Hg; r=0.92; %=4±0%). Without accounting for stenosis interaction, the value of FFR for each stenosis would have been significantly overestimated (0.85±0.08; P
AB - Background—When several stenoses are present within 1 coronary artery, the hemodynamic significance of each stenosis is influenced by the presence of the other(s), and the calculation of coronary and fractional flow reserve (CFR and FFR) for each individual stenosis is confounded. Recently, we developed and experimentally validated a method to determine the true FFR of each stenosis as it would be after the removal of the other stenosis; the true FFR can be reliably predicted by coronary pressures measured before treatment at specific locations within the coronary artery using equations accounting for stenosis interaction. The aim of the present study was to test the validity of these equations in humans.
Methods and Results—In this study of 32 patients with 2 serial stenoses in 1 coronary artery, relevant pressures were measured before the intervention, after the treatment of 1 stenosis, and after the treatment of both stenoses. The true FFR of each stenosis (FFRtrue) was directly measured after the elimination of the other stenosis and compared with the value predicted (FFRpred) from the initial pressure measurements before treatment. Although the hyperemic gradient across 1 stenosis increased significantly (from 10±7 to 19±11 mm Hg after treatment of the other stenosis), FFRpred was close to FFRtrue in all patients (0.78±0.12 versus 0.78±0.11 mm Hg; r=0.92; %=4±0%). Without accounting for stenosis interaction, the value of FFR for each stenosis would have been significantly overestimated (0.85±0.08; P
U2 - 10.1161/01.CIR.102.19.2371
DO - 10.1161/01.CIR.102.19.2371
M3 - Article
SN - 0009-7322
VL - 102
SP - 2371
EP - 2377
JO - Circulation
JF - Circulation
IS - 19
ER -