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Optimal Intravascular Ultrasound Criteria and Their Accuracy for Defining the Functional Significance of Intermediate Coronary Stenoses of Different Locations

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Author(s)
Bon-Kwon KooHyoung-Mo YangJun-Hyung DohHyunmin ChoeSung-Yun LeeChang-Hwan YoonYun-Kyeong ChoChang-Wook NamSeung-Ho HurHong-Seok LimMyeong-Ho YoonKyung-Woo ParkSang-Hoon NaTae-Jin YounWoo-Young ChungSeunghyun MaSue-Kyung ParkHyo-Soo KimSeung-Jea Tahk
Keimyung Author(s)
Cho, Yun KyeongNam, Chang WookHur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
JACC: Cardiovascular Interventions
Issued Date
2011
Volume
4
Issue
7
Keyword
coronary diseasefractional flow reserveintravascular ultrasoundphysiologystenosis
Abstract
Objectives:

We performed this study to determine the optimal intravascular ultrasound (IVUS) criteria and to evaluate their accuracy for defining the functional significance of intermediate coronary stenoses in different locations of the coronary tree.


Background:

Presence of myocardial ischemia is the most important prognostic factor in patients with coronary artery disease and is determined by both the lesion severity and the amount of myocardium supplied.


Methods:

IVUS and fractional flow reserve (FFR) measurements were performed in 267 intermediate lesions located at the proximal or mid part of major epicardial coronary arteries. Optimal IVUS criteria and their diagnostic accuracy for functionally significant stenoses (FFR <0.8) were assessed.


Results:

FFR was <0.8 in 88 lesions (33%). The determinants of FFR were minimum lumen area (MLA) and lesion location. The diagnostic accuracy of MLA was highly variable according to the location of lesions. The best cutoff value of MLA to define the functional significance was 3.0 mm2 (area under the curve [AUC]: 0.81, 95% confidence interval [CI]: 0.68 to 0.91) for proximal left anterior descending artery (LAD) lesions and 2.75 mm2 for mid-LAD lesions located before the second diagonal branch (AUC: 0.76, 95% CI: 0.66 to 0.84). However, the appropriate MLA to predict the functional significance of lesions could not be found in other segments.


Conclusions:

When IVUS parameters are used to determine the functional significance of lesions in patients with intermediate coronary artery stenoses, different criteria should be used according to lesion location. In segments or vessels with anatomic variations, IVUS cannot be used for functional assessment of a stenosis.
Keimyung Author(s)(Kor)
조윤경
남창욱
허승호
Publisher
School of Medicine
Citation
Bon-Kwon Koo et al. (2011). Optimal Intravascular Ultrasound Criteria and Their Accuracy for Defining the Functional Significance of Intermediate Coronary Stenoses of Different Locations. JACC: Cardiovascular Interventions, 4(7), 803–811. doi: 10.1016/j.jcin.2011.03.013
Type
Article
ISSN
1936-8798
DOI
10.1016/j.jcin.2011.03.013
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33904
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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