Seung-Yul Lee1, Dong-Ho Shin2, Islam Shehata3, Jung-Sun Kim2, Byeong-Keuk Kim2, Young-Guk Ko2, Donghoon Choi2, Yangsoo Jang4, Myeong-Ki Hong5. 1. Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Republic of Korea. 2. Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. Department of Cardiology, Zagazig University, Zagazig, Egypt. 4. Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. 5. Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: mkhong61@yuhs.ac.
Abstract
BACKGROUND: The assessment of fractional flow reserve (FFR) in coronary lesions determines the strategy of percutaneous coronary intervention. However, the association between FFR and characteristics of the underlying coronary plaque has not been sufficiently investigated. METHODS: A total of 110 coronary lesions in 106 patients were evaluated using both FFR and optical coherence tomography (OCT). Coronary plaques were classified into fibrous, fibrocalcific, or fibroatheroma according to OCT evaluation at the site of minimal lumen area. Plaque microstructures such as cap thickness, macrophage accumulation, intimal vasculature, or cholesterol crystals were also evaluated. RESULTS: Lesions with FFR≤0.8 showed a higher frequency of fibroatheroma, macrophage accumulation, and cholesterol crystals when compared to those with FFR>0.8. The angle of lipid was wider in lesions with FFR≤0.8 (145.1±63.0° vs. 120.7±48.9°, p=0.047), and the longitudinal length was longer in those with FFR≤0.8 (4.2±2.8mm vs. 2.5±2.9mm, p=0.007). However, multiple linear regression analysis revealed that the morphological characteristics of plaques assessed by OCT were not independently associated with FFR. Minimal lumen area [coefficient, 0.035; 95% confidence interval (CI), 0.022-0.048; p<0.001] and area stenosis (coefficient, -0.003; 95% CI, -0.005 to -0.001; p=0.001) assessed by OCT significantly correlated with FFR. CONCLUSION: The morphological characteristics of coronary plaque derived from OCT are not directly related to FFR.
BACKGROUND: The assessment of fractional flow reserve (FFR) in coronary lesions determines the strategy of percutaneous coronary intervention. However, the association between FFR and characteristics of the underlying coronary plaque has not been sufficiently investigated. METHODS: A total of 110 coronary lesions in 106 patients were evaluated using both FFR and optical coherence tomography (OCT). Coronary plaques were classified into fibrous, fibrocalcific, or fibroatheroma according to OCT evaluation at the site of minimal lumen area. Plaque microstructures such as cap thickness, macrophage accumulation, intimal vasculature, or cholesterol crystals were also evaluated. RESULTS: Lesions with FFR≤0.8 showed a higher frequency of fibroatheroma, macrophage accumulation, and cholesterol crystals when compared to those with FFR>0.8. The angle of lipid was wider in lesions with FFR≤0.8 (145.1±63.0° vs. 120.7±48.9°, p=0.047), and the longitudinal length was longer in those with FFR≤0.8 (4.2±2.8mm vs. 2.5±2.9mm, p=0.007). However, multiple linear regression analysis revealed that the morphological characteristics of plaques assessed by OCT were not independently associated with FFR. Minimal lumen area [coefficient, 0.035; 95% confidence interval (CI), 0.022-0.048; p<0.001] and area stenosis (coefficient, -0.003; 95% CI, -0.005 to -0.001; p=0.001) assessed by OCT significantly correlated with FFR. CONCLUSION: The morphological characteristics of coronary plaque derived from OCT are not directly related to FFR.
Authors: Mariusz Tomaniak; Dorota Ochijewicz; Łukasz Kołtowski; Adam Rdzanek; Arkadiusz Pietrasik; Jacek Jąkała; Magdalena Slezak; Krzysztof P Malinowski; Martyna Zaleska; Jakub Maksym; Piotr Barus; Tomasz Roleder; Krzysztof J Filipiak; Grzegorz Opolski; Janusz Kochman Journal: J Clin Med Date: 2021-05-28 Impact factor: 4.241