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The impact of microvascular resistance on the discordance between anatomical and functional evaluations of intermediate coronary disease

Authors
Seo, KW  | Lim, HS  | Yoon, MH  | Tahk, SJ  | Choi, SY  | Choi, BJ  | Yang, HM  | Shin, JH  | Hwang, GS  | Park, JS  | Jin, X
Citation
EuroIntervention, 13(2). : e185-e192, 2017
Journal Title
EuroIntervention
ISSN
1774-024X1969-6213
Abstract
AIMS: In intermediate coronary artery disease, discordance between anatomical and functional assessments persists and the diagnostic accuracy of an anatomical evaluation is not satisfactory for determining functional significance. We aimed to evaluate the impact of microvascular resistance on "anatomical-functional discordance".
METHODS AND RESULTS: In 97 intermediate coronary lesions of 83 patients, minimum lumen area (MLA), fractional flow reserve (FFR), Delta(Pd/Pa-FFR), and hyperaemic microvascular resistance index (hMVRI) were measured using intravascular ultrasound and an intracoronary dual pressure and Doppler sensor-tipped guidewire. hMVRI correlated with FFR and Delta(Pd/Pa-FFR) (r=0.611, p<0.001: r=-0.509, p<0.001: respectively). After the lesions were categorised into four groups based on functional significance (FFR 0.8) and the MLA cut-off for that (2.5 mm2), hMVRI was higher with a lower Delta(Pd/Pa-FFR) regardless of the MLA group in lesions with FFR >0.8, compared with those in lesions with FFR CONCLUSIONS: Coronary microvascular resistance is associated with anatomical-functional discordance and the ischaemic potential of intermediate epicardial stenosis. In determining a treatment strategy, anatomy alone is insufficient and an integrated physiologic approach is important.
MeSH

DOI
10.4244/EIJ-D-16-00400
PMID
28134124
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
Ajou Authors
박, 진선  |  서, 경우  |  신, 준한  |  양, 형모  |  윤, 명호  |  임, 홍석  |  최, 병주  |  최, 소연  |  탁, 승제  |  황, 교승
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