Abstract 8557: Arterial Hypotension Under-Estimates Functional Significance of Stenosis by FFR
Background It is widely aknowledged that hemodynamics in the cathlab don't influence FFR. Mathematic modelisations suggest however an inverse relationship between arterial pressure and FFR
Methods We prospectively studied coronary stenosis with FFR (IC 150 µg adenosin) in patients with mean arterial pressure (Pa) below 85 mmHg. We performed a second measurement after increasing Pa with 0.5 mg neosynephrin IV. The LVEF was normal and the explored-artery free of any history of ACS
Results From 2007 to 2010, 14 stenosis (mean stenosis 60±21%) in 12 patients (100% male, 59±11 y) with mean Pa=69 mmHg were studied. After neosynephrin injection Pa increases to 100 mmHg without cardiac frequency variation (65 bpm to 62 bpm). Mean FFR decreases from 0.81±0.11 to 0.75±0.12 (p<0.0001). Five lesions with initial 0.8≤FFR<0.9 dropped below the threshold of 0.80.
Conclusions In the clinical setting we confirm that in borderline physiological conditions, FFR is sensitive to perfusion pressure. In case of arterial hypotension during measurement, a non significant FFR <0.90 should be re-tested after normalisation of the arterial pressure.
- © 2011 by American Heart Association, Inc.