OBJECTIVE: In this multicentre study, we investigated the long-term prognostic value of intracoronary derived haemodynamic parameters compared with the results of myocardial perfusion scintigraphy (MPS). METHODS: Patients (n=191) who were referred for angioplasty of a severe lesion in the presence of an intermediate lesion in another coronary artery were included. MPS was performed to determine the presence of reversible perfusion defects in the area of the intermediate lesion. Coronary flow velocity reserve (CFVR), and additionally fractional flow reserve (FFR; n=129), were determined distal to the intermediate lesion; CFVR >/=2.0 and FFR >/=0.75 were considered negative. RESULTS: In total 67 events occurred in 49 patients (3 deaths, 9 MI, 9 CABG, 46 PTCA) during a mean of 793 days follow-up. Event-free survival was 63% for MPS, 79% for CFVR, and 79% for FFR if a negative test result was obtained. The relative risk was 1.2 (not significant) for MPS, 2.2 (p=0.001) for CFVR, and 2.4 (p=0.004) for FFR. CONCLUSION: Selective evaluation of an intermediate lesion using CFVR or FFR allows more adequate risk stratification in patients with multivessel disease than MPS. A CFVR <2.0 or a FFR <0.75 was associated with a significant increase of the occurrence of cardiac events during long-term follow-up, predominantly associated with revascularisation. (Neth Heart J 2007;15:369-74.).
OBJECTIVE: In this multicentre study, we investigated the long-term prognostic value of intracoronary derived haemodynamic parameters compared with the results of myocardial perfusion scintigraphy (MPS). METHODS:Patients (n=191) who were referred for angioplasty of a severe lesion in the presence of an intermediate lesion in another coronary artery were included. MPS was performed to determine the presence of reversible perfusion defects in the area of the intermediate lesion. Coronary flow velocity reserve (CFVR), and additionally fractional flow reserve (FFR; n=129), were determined distal to the intermediate lesion; CFVR >/=2.0 and FFR >/=0.75 were considered negative. RESULTS: In total 67 events occurred in 49 patients (3 deaths, 9 MI, 9 CABG, 46 PTCA) during a mean of 793 days follow-up. Event-free survival was 63% for MPS, 79% for CFVR, and 79% for FFR if a negative test result was obtained. The relative risk was 1.2 (not significant) for MPS, 2.2 (p=0.001) for CFVR, and 2.4 (p=0.004) for FFR. CONCLUSION: Selective evaluation of an intermediate lesion using CFVR or FFR allows more adequate risk stratification in patients with multivessel disease than MPS. A CFVR <2.0 or a FFR <0.75 was associated with a significant increase of the occurrence of cardiac events during long-term follow-up, predominantly associated with revascularisation. (Neth Heart J 2007;15:369-74.).
Authors: G J Bech; B De Bruyne; N H Pijls; E D de Muinck; J C Hoorntje; J Escaned; P R Stella; E Boersma; J Bartunek; J J Koolen; W Wijns Journal: Circulation Date: 2001-06-19 Impact factor: 29.690
Authors: Morton J Kern; Amir Lerman; Jan-Willen Bech; Bernard De Bruyne; Eric Eeckhout; William F Fearon; Stuart T Higano; Michael J Lim; Martijn Meuwissen; Jan J Piek; Nico H J Pijls; Maria Siebes; Jos A E Spaan Journal: Circulation Date: 2006-08-28 Impact factor: 29.690
Authors: Daniel S Berman; Rory Hachamovitch; Leslee J Shaw; John D Friedman; Sean W Hayes; Louise E J Thomson; David S Fieno; Guido Germano; Nathan D Wong; Xingping Kang; Alan Rozanski Journal: J Nucl Med Date: 2006-07 Impact factor: 10.057
Authors: H W Strauss; D D Miller; M D Wittry; M D Cerqueira; E V Garcia; A S Iskandrian; H R Schelbert; F J Wackers Journal: J Nucl Med Date: 1998-05 Impact factor: 10.057
Authors: S A J Chamuleau; B L F van Eck-Smit; M Meuwissen; K T Koch; M G W Dijkgraaf; H J Verberne; J G P Tijssen; J J Piek Journal: Neth Heart J Date: 2007 Impact factor: 2.380
Authors: N H Pijls; B De Bruyne; K Peels; P H Van Der Voort; H J Bonnier; J J Bartunek J Koolen; J J Koolen Journal: N Engl J Med Date: 1996-06-27 Impact factor: 91.245
Authors: E E van der Wall; J E van Velzen; F R de Graaf; M M Boogers; J D Schuijf; J J Bax Journal: Int J Cardiovasc Imaging Date: 2010-04-16 Impact factor: 2.357
Authors: S A J Chamuleau; B L F van Eck-Smit; M Meuwissen; K T Koch; M G W Dijkgraaf; H J Verberne; J G P Tijssen; J J Piek Journal: Neth Heart J Date: 2007 Impact factor: 2.380