BACKGROUND: Collateral fractional flow reserve (FFR(coll)) is an index to quantify collateral blood flow, derived from coronary pressure measurements. Although well defined theoretically, its direct validation by myocardial perfusion imaging has not been established so far. Validating this index by myocardial perfusion imaging is the main aim of this study. METHODS AND RESULTS: Twenty-four consecutive patients with stable angina and single left anterior descending artery stenosis underwent simultaneous measurement of aortic pressure (P(a)), coronary wedge pressure (P(w)), and central venous pressure (P(v)) during balloon inflation. FFR(coll) was calculated and compared with the extent and severity of the defect during coronary occlusion using (99m)Tc-sestamibi imaging at balloon inflation of the respective coronary artery. Although the pressure-derived collateral indexes (P(w), P(w)/P(a), and FFR(coll)) ranged widely, they were closely correlated with extent and severity scores of the nuclear occlusion images and superior to the ECG for that purpose. Of all parameters, FFR(coll) correlated best with the severity score at imaging (r=-0.88), followed by the P(w)/P(a) ratio (r=-0.74) or P(w) alone (r=-0.69). CONCLUSIONS: FFR(coll), calculated from coronary pressure during balloon occlusion, is highly correlated with the extent and severity of the defect at myocardial perfusion of the territory of the occluded artery and can be used for quantitative assessment of collateral blood flow in conscious humans.
BACKGROUND: Collateral fractional flow reserve (FFR(coll)) is an index to quantify collateral blood flow, derived from coronary pressure measurements. Although well defined theoretically, its direct validation by myocardial perfusion imaging has not been established so far. Validating this index by myocardial perfusion imaging is the main aim of this study. METHODS AND RESULTS: Twenty-four consecutive patients with stable angina and single left anterior descending artery stenosis underwent simultaneous measurement of aortic pressure (P(a)), coronary wedge pressure (P(w)), and central venous pressure (P(v)) during balloon inflation. FFR(coll) was calculated and compared with the extent and severity of the defect during coronary occlusion using (99m)Tc-sestamibi imaging at balloon inflation of the respective coronary artery. Although the pressure-derived collateral indexes (P(w), P(w)/P(a), and FFR(coll)) ranged widely, they were closely correlated with extent and severity scores of the nuclear occlusion images and superior to the ECG for that purpose. Of all parameters, FFR(coll) correlated best with the severity score at imaging (r=-0.88), followed by the P(w)/P(a) ratio (r=-0.74) or P(w) alone (r=-0.69). CONCLUSIONS: FFR(coll), calculated from coronary pressure during balloon occlusion, is highly correlated with the extent and severity of the defect at myocardial perfusion of the territory of the occluded artery and can be used for quantitative assessment of collateral blood flow in conscious humans.
Authors: Marcus Hacker; Johannes Rieber; Rupert Schmid; Christian Lafougere; Andreas Tausig; Karl Theisen; Volker Klaus; Reinhold Tiling Journal: J Nucl Cardiol Date: 2005 Nov-Dec Impact factor: 5.952
Authors: Stephen P Hoole; Paul A White; Philip A Read; Patrick M Heck; Nick E West; Michael O'Sullivan; David P Dutka Journal: J Appl Physiol (1985) Date: 2012-02-09
Authors: Stefan Förster; Johannes Rieber; Christopher Ubleis; Mayo Weiss; Peter Bartenstein; Paul Cumming; Volker Klauss; Marcus Hacker Journal: Int J Cardiovasc Imaging Date: 2009-09-16 Impact factor: 2.357
Authors: Jessica de Vries; Rutger L Anthonio; Mike J L Dejongste; Gillian A Jessurun; Eng-Shiong Tan; Bart J G L de Smet; Ad F M van den Heuvel; Michiel J Staal; Felix Zijlstra Journal: BMC Cardiovasc Disord Date: 2007-06-27 Impact factor: 2.298