BACKGROUND: The decision-making process of patients with angiographically-intermediate coronary lesions (ICL) is clinically challenging and may benefit from adjunctive invasive techniques. Fractional-flow-reserve (FFR) represents the gold standard to evaluate ICL but frequency-domain optical-coherence-tomography (OCT) is a novel, promising, high resolution coronary imaging technique, which allows physiopathologic assessment of coronary plaque. We investigated the possible relation between OCT and FFR in selected ICL patients. METHODS: Stable or unstable patients with ICL who underwent both FFR and OCT assessment at two large tertiary centers were retrospectively enrolled. FFR was performed according to standard methodology. OCT images were (on blind to clinical and FFR results) analyzed to assess minimal lumen area (MLA), percentage area stenosis (AS), thrombus and plaque ulceration. RESULTS: Forty patients were identified (62±10years, 93% symptomatic, 35% acute presentation, 93% left-anterior-descending artery ICL). Percentage diameter stenosis at quantitative coronary angiography was 40±12% and FFR was 0.85±0.07. MLA (p=0.009), AS (p<0.001) and plaque ulceration (p=0.02) were significantly associated with FFR values. An integrated assessment of AS (≥ or <70%), MLA (≥ or <2.5mm2) and presence or absence of thrombus and plaque ulceration was found to have the potential to accurately (sensitivity 91%, specificity 93%) predict FFR results. CONCLUSION: In patients with ICL, a combination of different OCT parameters may help predict FFR results. These findings suggest that only a comprehensive assessment of lesion features by OCT can allow an accurate prediction of lesion severity assessed by FFR.
BACKGROUND: The decision-making process of patients with angiographically-intermediate coronary lesions (ICL) is clinically challenging and may benefit from adjunctive invasive techniques. Fractional-flow-reserve (FFR) represents the gold standard to evaluate ICL but frequency-domain optical-coherence-tomography (OCT) is a novel, promising, high resolution coronary imaging technique, which allows physiopathologic assessment of coronary plaque. We investigated the possible relation between OCT and FFR in selected ICLpatients. METHODS: Stable or unstable patients with ICL who underwent both FFR and OCT assessment at two large tertiary centers were retrospectively enrolled. FFR was performed according to standard methodology. OCT images were (on blind to clinical and FFR results) analyzed to assess minimal lumen area (MLA), percentage area stenosis (AS), thrombus and plaque ulceration. RESULTS: Forty patients were identified (62±10years, 93% symptomatic, 35% acute presentation, 93% left-anterior-descending artery ICL). Percentage diameter stenosis at quantitative coronary angiography was 40±12% and FFR was 0.85±0.07. MLA (p=0.009), AS (p<0.001) and plaque ulceration (p=0.02) were significantly associated with FFR values. An integrated assessment of AS (≥ or <70%), MLA (≥ or <2.5mm2) and presence or absence of thrombus and plaque ulceration was found to have the potential to accurately (sensitivity 91%, specificity 93%) predict FFR results. CONCLUSION: In patients with ICL, a combination of different OCT parameters may help predict FFR results. These findings suggest that only a comprehensive assessment of lesion features by OCT can allow an accurate prediction of lesion severity assessed by FFR.
Authors: Makoto Araki; Seung-Jung Park; Harold L Dauerman; Shiro Uemura; Jung-Sun Kim; Carlo Di Mario; Thomas W Johnson; Giulio Guagliumi; Adnan Kastrati; Michael Joner; Niels Ramsing Holm; Fernando Alfonso; William Wijns; Tom Adriaenssens; Holger Nef; Gilles Rioufol; Nicolas Amabile; Geraud Souteyrand; Nicolas Meneveau; Edouard Gerbaud; Maksymilian P Opolski; Nieves Gonzalo; Guillermo J Tearney; Brett Bouma; Aaron D Aguirre; Gary S Mintz; Gregg W Stone; Christos V Bourantas; Lorenz Räber; Sebastiano Gili; Kyoichi Mizuno; Shigeki Kimura; Toshiro Shinke; Myeong-Ki Hong; Yangsoo Jang; Jin Man Cho; Bryan P Yan; Italo Porto; Giampaolo Niccoli; Rocco A Montone; Vikas Thondapu; Michail I Papafaklis; Lampros K Michalis; Harmony Reynolds; Jacqueline Saw; Peter Libby; Giora Weisz; Mario Iannaccone; Tommaso Gori; Konstantinos Toutouzas; Taishi Yonetsu; Yoshiyasu Minami; Masamichi Takano; O Christopher Raffel; Osamu Kurihara; Tsunenari Soeda; Tomoyo Sugiyama; Hyung Oh Kim; Tetsumin Lee; Takumi Higuma; Akihiro Nakajima; Erika Yamamoto; Krzysztof L Bryniarski; Luca Di Vito; Rocco Vergallo; Francesco Fracassi; Michele Russo; Lena M Seegers; Iris McNulty; Sangjoon Park; Marc Feldman; Javier Escaned; Francesco Prati; Eloisa Arbustini; Fausto J Pinto; Ron Waksman; Hector M Garcia-Garcia; Akiko Maehara; Ziad Ali; Aloke V Finn; Renu Virmani; Annapoorna S Kini; Joost Daemen; Teruyoshi Kume; Kiyoshi Hibi; Atsushi Tanaka; Takashi Akasaka; Takashi Kubo; Satoshi Yasuda; Kevin Croce; Juan F Granada; Amir Lerman; Abhiram Prasad; Evelyn Regar; Yoshihiko Saito; Mullasari Ajit Sankardas; Vijayakumar Subban; Neil J Weissman; Yundai Chen; Bo Yu; Stephen J Nicholls; Peter Barlis; Nick E J West; Armin Arbab-Zadeh; Jong Chul Ye; Jouke Dijkstra; Hang Lee; Jagat Narula; Filippo Crea; Sunao Nakamura; Tsunekazu Kakuta; James Fujimoto; Valentin Fuster; Ik-Kyung Jang Journal: Nat Rev Cardiol Date: 2022-04-21 Impact factor: 49.421
Authors: Antonio Maria Leone; Francesco Burzotta; Cristina Aurigemma; Giovanni Luigi De Maria; Aniello Zambrano; Giuseppe Zimbardo; Manfredi Arioti; Emma Cerracchio; Rocco Vergallo; Carlo Trani; Filippo Crea Journal: J Am Heart Assoc Date: 2019-07-23 Impact factor: 5.501
Authors: Konstantina P Bouki; Delia I Vlad; Nikolaos Goulas; Vaia A Lambadiari; George D Dimitriadis; Athanasios A Kotsakis; Kyriaki Barοutsi; Konstantinos P Toutouzas Journal: J Interv Cardiol Date: 2021-11-15 Impact factor: 2.279
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