BACKGROUND: optical coherence tomography (OCT) might allow identifying lesion features reportedly associated with plaque vulnerability and increased risk of clinical events. Previous studies on correlation between OCT and functional lesion significance indices reported contradictory results, yet integration of complementary information from both modalities is gaining increased interest. The aim of the study was to compare plaque morphology using OCT in hemodynamically relevant vs. non-relevant lesions by fractional flow reserve (FFR). METHODS: consecutive patients with intermediate grade coronary stenoses by angiography were evaluated by both FFR and OCT in this single-center study. Stenoses were labeled hemodynamically relevant in case of the FFR ≤ 0.80. Minimal lumen area (MLA), fibrous cap thickness (FCT), minimal cap thickness over the calcium, angle of the calcium, and necrotic core within the lesions were evaluated. RESULTS: a total of 105 patients (124 vessels) were analyzed. Of them, 65 patients were identified with at least one lesion identified as hemodynamically relevant by FFR (72 vessels, 58.1%). Lesions with FFR ≤0.80 presented with lower mean and minimal lumen area (3.46 ± 1.29 vs. 4.65 ± 2.19, p =0.001 and 1.84 ± 0.97 vs. 2.66 ± 1.40, p = 0.001) compared to patients with FFR > 0.80. No differences were found between groups in the mean and minimal FCT, mean, and maximal necrotic core, calcium angle, as well as the overall rate of calcified and lipid plaques. CONCLUSION: hemodynamic relevance of intermediate grade lesions correlated moderately with the luminal assessment by OCT. No differences were identified in the plaque morphology between relevant and non-relevant coronary stenoses by FFR.
BACKGROUND: optical coherence tomography (OCT) might allow identifying lesion features reportedly associated with plaque vulnerability and increased risk of clinical events. Previous studies on correlation between OCT and functional lesion significance indices reported contradictory results, yet integration of complementary information from both modalities is gaining increased interest. The aim of the study was to compare plaque morphology using OCT in hemodynamically relevant vs. non-relevant lesions by fractional flow reserve (FFR). METHODS: consecutive patients with intermediate grade coronary stenoses by angiography were evaluated by both FFR and OCT in this single-center study. Stenoses were labeled hemodynamically relevant in case of the FFR ≤ 0.80. Minimal lumen area (MLA), fibrous cap thickness (FCT), minimal cap thickness over the calcium, angle of the calcium, and necrotic core within the lesions were evaluated. RESULTS: a total of 105 patients (124 vessels) were analyzed. Of them, 65 patients were identified with at least one lesion identified as hemodynamically relevant by FFR (72 vessels, 58.1%). Lesions with FFR ≤0.80 presented with lower mean and minimal lumen area (3.46 ± 1.29 vs. 4.65 ± 2.19, p =0.001 and 1.84 ± 0.97 vs. 2.66 ± 1.40, p = 0.001) compared to patients with FFR > 0.80. No differences were found between groups in the mean and minimal FCT, mean, and maximal necrotic core, calcium angle, as well as the overall rate of calcified and lipid plaques. CONCLUSION: hemodynamic relevance of intermediate grade lesions correlated moderately with the luminal assessment by OCT. No differences were identified in the plaque morphology between relevant and non-relevant coronary stenoses by FFR.
Authors: Gregg W Stone; Akiko Maehara; Ziad A Ali; Claes Held; Mitsuaki Matsumura; Lars Kjøller-Hansen; Hans Erik Bøtker; Michael Maeng; Thomas Engstrøm; Rune Wiseth; Jonas Persson; Thor Trovik; Ulf Jensen; Stefan K James; Gary S Mintz; Ovidiu Dressler; Aaron Crowley; Ori Ben-Yehuda; David Erlinge Journal: J Am Coll Cardiol Date: 2020-10-15 Impact factor: 24.094
Authors: Francesco Burzotta; Roberto Nerla; Jonathan Hill; Lazzaro Paraggio; Antonio Maria Leone; Jonathan Byrne; Italo Porto; Giampaolo Niccoli; Cristina Aurigemma; Carlo Trani; Philip MacCarthy; Filippo Crea Journal: Int J Cardiol Date: 2018-02-15 Impact factor: 4.164
Authors: Annapoorna S Kini; Sadako Motoyama; Yuliya Vengrenyuk; Jonathan E Feig; Jacobo Pena; Usman Baber; Arjun M Bhat; Pedro Moreno; Jason C Kovacic; Jagat Narula; Samin K Sharma Journal: JACC Cardiovasc Interv Date: 2015-06 Impact factor: 11.195
Authors: Mark W Kennedy; Enrico Fabris; Alexander J Ijsselmuiden; Holger Nef; Sebastian Reith; Javier Escaned; Fernando Alfonso; Niels van Royen; Wojtek Wojakowski; Adam Witkowski; Ciro Indolfi; Jan Paul Ottervanger; Harry Suryapranata; Elvin Kedhi Journal: Cardiovasc Diabetol Date: 2016-10-10 Impact factor: 9.951