Gravedad de la enfermedad coronaria definida por ultrasonido intravascular o tomografía de coherencia óptica y su relación con los índices fisiológicos

Translated title of the contribution: Intravascular ultrasound or optical coherence tomography-defined anatomic severity and hemodynamic severity assessed by coronary physiologic indices

Joo Myung Lee, Ki Hong Choi, Bon Kwon Koo, Jinlong Zhang, Jung Kyu Han, Han Mo Yang, Kyung Woo Park, Young Bin Song, Joo Yong Hahn, Seung Hyuk Choi, Hyeon Cheol Gwon, Hyo Soo Kim

Research output: Contribution to journalArticle

Abstract

Introduction and objectives: Fractional flow reserve or instantaneous wave-free ratio has become a standard criterion for revascularization. We sought to evaluate the association between intravascular ultrasound (IVUS) or optical coherence tomography (OCT)-derived quantitative plaque characteristics and the severity of physiologic stenosis. Methods: A total of 365 stenoses from 330 patients were evaluated. The association between IVUS or OCT-derived parameters and resting physiologic indices (instantaneous wave-free ratio, resting full-cycle ratio, and diastolic pressure ratio) and fractional flow reserve were explored. Results: Among the total number of lesions, 50.7% and 58.1% showed an instantaneous wave-free ratio ≤ 0.89 and fractional flow reserve ≤ 0.80, respectively. IVUS or OCT-derived parameters showed significant correlations with resting physiologic indices (P values <.005). The best cutoff values of IVUS minimum lumen area (MLA), plaque burden, OCT-MLA, and OCT-area stenosis to predict functional significance were the same (IVUS-MLA: 3.4 mm2, plaque burden: 72.0%, OCT-MLA: 2.0 mm2, OCT-area stenosis: 68.0%) for all resting physiologic indices (instantaneous wave-free ratio, resting full-cycle ratio, and diastolic pressure ratio). The best cutoff values for fractional flow reserve were an IVUS-MLA of 3.8 mm2, plaque burden of 70.0%, OCT-MLA of 2.3 mm2, and OCT-area stenosis of 65.0%. Regardless of IVUS or OCT-derived parameters, the overall diagnostic accuracies of the parameters were lower than 70% and discrimination indices were less than 0.75 for resting physiologic indices or fractional flow reserve. Conclusions: The resting physiologic indices showed an identical relationship with IVUS or OCT-defined quantitative plaque characteristics. The diagnostic accuracy and discrimination ability of anatomical parameters were modest in predicting functional significance defined by resting and hyperemic invasive physiologic indices. This trial is registered at ClinicalTrials.gov (Identifier: NCT03795714).

Translated title of the contributionIntravascular ultrasound or optical coherence tomography-defined anatomic severity and hemodynamic severity assessed by coronary physiologic indices
Original languageSpanish
JournalRevista Espanola de Cardiologia
DOIs
StatePublished - 2020

Keywords

  • Coronary artery disease
  • Diastolic pressure ratio
  • Fractional flow reserve
  • Instantaneous wave-free ratio
  • Intravascular ultrasound
  • Ischemia
  • Resting full-cycle ratio

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