Abstract 14070: Significant Correlation Between Coronary Fractional Flow Reserve and Dobutamine Stress Echocardiography in Patients With Moderate Coronary Artery Disease
Introduction: Both the fractional flow reserve (FFR) measurement and the dobutamine stress echo (DSE) are accepted diagnostic methods to indicate revascularisation of a moderate coronary stenosis (CAS). The prospective comparative data of these two functional tests are limited for CAS in stable (SCAD) and bystander coronary artery disease. We sought to compare these tests in these clinical settings in a prospective study.
Methods: Patients were included with CAS (30-70 % diameter) either with SCAD or bystander coronary artery disease revealed by coronary angiogram performed for ACS treatment. In this case the culprit vessel was excluded and the FFR study was deferred for a month. The FFR study was performed within 4 weeks of DSE. The target vessel considered abnormal if FFR was <0.8. The DSE was identified as positive if new wall motion abnormality was detected in ≥2 segments supplied by the target vessel. In the patient-based analysis FFR positive patients had at least one abnormal vessel, DSE positive patients had new wall motion abnormality in ≥2 segments.
Results: Hundred and thirty-eight stenotic coronary arteries (91 LAD, 22 LCx and 25 RCA) were investigated in 111 patients (80 male, age: 60.7±0.88 years, ejection fraction 53.7±1.06%, bystander lesion in 30.4%). The sensitivity, specificity and concordance of DSE for detecting a vessel with FFR<0.8 was 32.7 %, 89.9 % and 69.6 %, respectively (χ 2(1) =10.82, p<0.001; Table). For detecting a patient with abnormal FFR the sensitivity, specificity and concordance of DSE was 37.2%, 86.7% and 67.5 % respectively (χ2(1)=8.68, p=0.003; Table). The correlation between FFR and DSE was significant in both analysis (p<0.001; p<0.003; respectively).
Conclusion: Our prospective trial showed a significant correlation between DSE and FFR for the assessment of moderate coronary stenosis. The prognosis of patients with discordant functional tests should be evaluated to find out what is the optimal treatment strategy in these cases.
Author Disclosures: A. Ahres: None. B. Jablonkai: None. G. Rubóczky: None. Á. Oze: None. Z. Szigeti: None. B. Nagybaczoni: None. Z.D. Balogh: None. A. Apor: None. K. Wohlfart: None. P. Andrássy: None.
- © 2016 by American Heart Association, Inc.