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Usefulness of combined intravascular ultrasound parameters to predict functional significance of coronary artery stenosis and determinants of mismatch.

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dc.contributor.authorCho, YK-
dc.contributor.authorNam, CW-
dc.contributor.authorHan, JK-
dc.contributor.authorKoo, BK-
dc.contributor.authorDoh, JH-
dc.contributor.authorBen-Dor, I-
dc.contributor.authorWaksman, R-
dc.contributor.authorPichard, A-
dc.contributor.authorMurata, N-
dc.contributor.authorTanaka, N-
dc.contributor.authorLee, CH-
dc.contributor.authorGonzalo, N-
dc.contributor.authorEscaned, J-
dc.contributor.authorCosta, MA-
dc.contributor.authorKubo, T-
dc.contributor.authorAkasaka, T-
dc.contributor.authorHu, X-
dc.contributor.authorWang, JA-
dc.contributor.authorYang, HM-
dc.contributor.authorYoon, MH-
dc.contributor.authorTahk, SJ-
dc.contributor.authorYoon, HJ-
dc.contributor.authorChung, IS-
dc.contributor.authorHur, SH-
dc.contributor.authorKim, KB-
dc.date.accessioned2017-03-28T06:22:12Z-
dc.date.available2017-03-28T06:22:12Z-
dc.date.issued2015-
dc.identifier.issn1774-024X-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/13662-
dc.description.abstractAIMS: Efficacy of combined intravascular ultrasound (IVUS) parameters in functional significance prediction and discrepancy between IVUS and fractional flow reserve (FFR) have not been well defined. This study therefore aimed to: 1) evaluate the diagnostic accuracy of combined IVUS parameters, namely minimal lumen area (MLA) and percent plaque burden (%PB), in functional significance prediction of coronary artery stenosis; and 2) define factors that affect the relation between FFR value and IVUS parameters.

METHODS AND RESULTS: At 11 international centres, IVUS and FFR measurements were concurrently performed in 945 major epicardial coronary artery lesions (886 patients). Functional significance was defined as FFR ≤0.8. MLA and FFR correlated weakly (r=0.289, p<0.001). Diagnostic accuracy of MLA ≤4.0 mm2, %PB >70% and their combination were 50%, 47% and 51%, respectively, with similar area under the curve (AUC) of 0.561, 0.511 and 0.516, respectively. The best cut-off values (BCV) were MLA ≤3.0 mm2 and %PB >75%, with accuracy of 60% for MLA, 50% for %PB and 56% for their combination, and AUC of 0.618, 0.511 and 0.533, respectively. MLA BCV ≤3.0 mm2 had higher predictive power than %PB BCV >75% or their combination. Independent predictors of functional significance were male gender (odds ratio 1.76 [95% confidence interval: 1.19-2.62]), left ventricular ejection fraction (LVEF, 0.98 [0.96-0.99]), LAD lesion (2.52 [1.73-3.67]), reference vessel diameter (0.60 [0.41-0.86]), lesion length (1.04 [1.02-1.06]) and MLA (0.79 [0.69-0.92]). False negative lesion incidence was 24.4% in association with race (for Asians, 0.391 [0.219-0.698]), LAD lesion (2.677 [1.709-4.191]) and LVEF (0.977 [0.957-0.997]). False positive lesion incidence was 17.0% in association with non-LAD lesion (2.444 [1.620-3.686]).

CONCLUSIONS: Combined IVUS parameters did not improve the accuracy of functional significance prediction. Discrepancy between IVUS and FFR, which was not rare, should be taken into account in clinical decision making.
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dc.language.isoen-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHCoronary Angiography-
dc.subject.MESHCoronary Stenosis-
dc.subject.MESHFemale-
dc.subject.MESHFractional Flow Reserve, Myocardial-
dc.subject.MESHHeart-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHSeverity of Illness Index-
dc.subject.MESHUltrasonography, Interventional-
dc.titleUsefulness of combined intravascular ultrasound parameters to predict functional significance of coronary artery stenosis and determinants of mismatch.-
dc.typeArticle-
dc.identifier.pmid26093837-
dc.identifier.urlhttp://www.pcronline.com/eurointervention/85th_issue/30-
dc.contributor.affiliatedAuthor양, 형모-
dc.contributor.affiliatedAuthor윤, 명호-
dc.contributor.affiliatedAuthor탁, 승제-
dc.type.localJournal Papers-
dc.identifier.doi10.4244/EIJV11I2A30-
dc.citation.titleEuroIntervention-
dc.citation.volume11-
dc.citation.number2-
dc.citation.date2015-
dc.citation.startPage163-
dc.citation.endPage170-
dc.identifier.bibliographicCitationEuroIntervention, 11(2). : 163-170, 2015-
dc.identifier.eissn1969-6213-
dc.relation.journalidJ01774024X-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
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