Author + information
- Yoshiharu Fujimoria,b,
- Satoshi Hashimotoa,b,
- Kenichiro Ebisudaa,b,
- Kazuto Kuriharaa,b,
- Yasushi Yamanakaa,b,
- Tomoko Babaa,b,
- Tomoyuki Sekia,b,
- Shigeru Nishiyamaa,b,
- Shiho Mizutania,b,
- Kyohei Yamazakia,b,
- Tadamasa Wakabayashia,b and
- Taku Imaia,b
Background: Fractional flow reserve (FFR) assessed by intravenous administration of adenosine triphosphate (ATP) has been recognized as an important index for evaluating functional significance of coronary artery stenosis. On the other hand, a single intracoronary bolus of saline also lowers post-stenotic pressure due to its low viscosity. We hypothesized that saline induced Pd/Pa ratio (SPR) might be useful index as well as FFR.
Methods: Among patients with coronary artery stenosis (diameter stenosis > 50%), we first measured SPR by intracoronary saline injection (2 ml/sec) for 5 heart beats, and then FFR by intravenous ATP infusion (140 mcg/kg/min).
Results: We enrolled 65 patients with 74 coronary stenoses (men 65%, 72.9±9.8 years old) in this study. As shown in Figure below, there was a significant correlation between FFR and SPR (R2=0.904). The SPR cut-off value corresponding to FFR <0.80 was 0.85 (Youden index), with sensitivity of 77% and specificity of 95%. Lowered SPR recovered fully to the baseline level within 10 to 15 heart beats. No complication such as arrhythmia, hypotension, and chest pain was observed.
Conclusions: SPR measurement is a simple, safe, less time-consuming and costless procedure to evaluate coronary artery stenosis, and has remarkably high reliability and easy repeatability. When using SPR, we only need to measure current FFR in patients with gray zone SPR (0.83–0.91, accounting for 29% of this study), and do not need FFR measurement in the residual majority of patients.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Interventional Cardiology: Intravascular Physiology and Endothelial Function
Abstract Category: 23. Interventional Cardiology: IVUS and Intravascular Physiology
Presentation Number: 1115-167
- 2017 American College of Cardiology Foundation