BACKGROUND: Coronary angiography is limited by its inability to assess the hemodynamic significance of a coronary artery stenosis. The assessment of the physiological significance of saphenous vein graft (SVG) lesions with a pressure wire to determine the fractional flow reserve (FFR) is lacking. METHODS: FFR was determined in 10 SVG lesions of 10 males who had stress myocardial perfusion imaging (MPI) prior to referral for percutaneous coronary intervention for clinical indications. RESULTS: All SVGs had a diameter stenosis (DS) > 50% and 30% had a DS > or = 70%. A significant FFR was present in 30% of patients. Ischemia along the territory of the SVG was present in 20% of patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FFR < 0.75 for the detection of ischemia on stress MPI were 50, 75, 33, 85, and 70%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FFR < 0.75 for detecting > or = 70% DS on angiography were 33, 71, 33, 71, and 60%, respectively. There was no significant correlation between FFR and % DS (R(2) = 0.1, P = 0.35). CONCLUSION: The use of FFR to assess the physiological significance of SVG lesions is feasible and provides an acceptable specificity and negative predictive value compared to stress MPI. 2008 Wiley-Liss, Inc.
BACKGROUND: Coronary angiography is limited by its inability to assess the hemodynamic significance of a coronary artery stenosis. The assessment of the physiological significance of saphenous vein graft (SVG) lesions with a pressure wire to determine the fractional flow reserve (FFR) is lacking. METHODS: FFR was determined in 10 SVG lesions of 10 males who had stress myocardial perfusion imaging (MPI) prior to referral for percutaneous coronary intervention for clinical indications. RESULTS: All SVGs had a diameter stenosis (DS) > 50% and 30% had a DS > or = 70%. A significant FFR was present in 30% of patients. Ischemia along the territory of the SVG was present in 20% of patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FFR < 0.75 for the detection of ischemia on stress MPI were 50, 75, 33, 85, and 70%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FFR < 0.75 for detecting > or = 70% DS on angiography were 33, 71, 33, 71, and 60%, respectively. There was no significant correlation between FFR and % DS (R(2) = 0.1, P = 0.35). CONCLUSION: The use of FFR to assess the physiological significance of SVG lesions is feasible and provides an acceptable specificity and negative predictive value compared to stress MPI. 2008 Wiley-Liss, Inc.
Authors: Manesh R Patel; John H Calhoon; Gregory J Dehmer; James Aaron Grantham; Thomas M Maddox; David J Maron; Peter K Smith Journal: J Nucl Cardiol Date: 2017-10 Impact factor: 5.952
Authors: Jing Li; Muhamad Y Elrashidi; Andreas J Flammer; Ryan J Lennon; Malcolm R Bell; David R Holmes; John F Bresnahan; Charanjit S Rihal; Lilach O Lerman; Amir Lerman Journal: Eur Heart J Date: 2013-01-23 Impact factor: 29.983
Authors: Ying-Hua Zhang; Jing Li; Andreas J Flammer; Yoshiki Matsuo; Moo-Sik Lee; Ryan J Lennon; Malcolm R Bell; David R Holmes; John F Bresnahan; Charanjit S Rihal; Lilach O Lerman; Amir Lerman Journal: J Geriatr Cardiol Date: 2019-04 Impact factor: 3.327