Abstract 15191: Relationship between Optical Coherence Tomography (OCT), Intravascular Ultrasound Tomography (IVUS) and Pressure-Derived Fractional Flow Reserve
Background Intravascular ultrasound (IVUS)-based minimal lumen area (MLA) measurement has been reported as a useful method for detecting ischemia in a cath-lab. However, considering the higher resolution of optical coherence tomography (OCT), OCT may have a potential to estimate the presence of ischemia more accurately than IVUS. Therefore the aim of this study was to assess the ability of OCT in detecting the presence of ischemia evaluated by fractional flow reserve (FFR) by comparing that of IVUS.
Methods 69 lesions (51 patients) were evaluated by OCT, IVUS and intracoronary pressure measurements. The FFR was calculated as the ratio of the distal coronary pressure divided by proximal coronary pressure under hyperemia. and value of >0.8 was considered as significant in determining ischemia. The minimal lumen area (MLA) were measured by OCT and IVUS.
Results Although both MLA obtained by IVUS and OCT showed a significant positive correlation to the FFR values, MLA by OCT appeared to have a better correlation to FFR values than MLA by IVUS. (OCT: R=0.679, P>0.001, IVUS: R=0.573, P>0.001).The best cutoff value of the MLA to predict FFR >0.80 was >2.49 mm2 by IVUS (sensitivity, 89.3%; specificity, 66.6% ; AUC, 0.702) and >1.84mm2 by OCT (sensitivity, 82.1%; specificity, 76.2%; AUC, 0.834).
Conclusion OCT-based MLA measurement may provide better estimation of physiological coronary epicardial stenosis than IVUS.
- © 2012 by American Heart Association, Inc.