Abstract 11979: Impact of Lesion Morphology on Physiological Significance of Intermediate Coronary Lesions
Introduction: Fractional flow reserve (FFR) has been recognized as helpful index to assess physiological significance of intermediate coronary lesions. Previous studies reported the discrepancy between angiographic severity and FFR. However, it was not fully understood whether the difference of lesion morphology affected FFR. Therefore, we assessed the impact of lesion morphology on FFR in intermediate coronary lesions.
Methods: The study included 109 consecutive patients with 124 intermediate lesions (40-60% diameter stenosis (DS) on quantitative coronary angiography). All intermediate lesions were examined FFR measurements and evaluated the following 7 types of lesion morphology; tandem, eccentric, angulated, irregular, calcified, bifurcation, and diffuse (length >20mm). We assessed DS and FFR between the presence and the absence in these 7 types of morphology. Then, we assessed the correlations between the number of morphological components, DS, and FFR.
Results: In 124 intermediate lesions, mean DS was 50.9±5.5% and mean FFR was 0.80±0.11. There was no correlation between DS and FFR (r=-0.066, p=0.468) in all subject. In all morphological values, DS was similar between the presence and the absence of them. However, the presence of tandem (n=34), eccentric (n=70), irregular (n=34), calcified (n=22), bifurcation (n=43), and diffuse (n=48) showed significantly lower FFR than the absence of them (0.73±0.11 vs. 0.82±0.11, p<0.001; 0.77±0.11 vs. 0.84±0.10, p<0.001; 0.74±0.12 vs. 0.82±0.11, p=0.001; 0.75±0.11 vs. 0.81±0.11, p=0.040; 0.75±0.10 vs. 0.82±0.11, p<0.001; 0.75±0.11 vs. 0.83±0.10, p<0.001, respectively). There was no difference of FFR on angulated (n=15, 0.81±0.08 vs. 0.79±0.11, p=0.522). Although there was no correlation between increasing number of these morphological components and DS (r=-0.102, p=0.262), there was a significant inverse correlation between increasing number of these morphological components and FFR (r=-0.497, p<0.001).
Conclusion: This study demonstrates that the angiographic severity not but the difference of lesion morphology affects FFR. Furthermore, the clustering of lesion morphology can show the significant impact on the physiological significance of intermediate coronary lesions.
- Coronary circulation
- Cardiovascular imaging
- Coronary artery disease
- Interventional cardiology
- © 2011 by American Heart Association, Inc.