Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Year : 2015  |  Volume : 28  |  Issue : 2  |  Page : 392-399

Fractional flow reserve and intravascular ultrasound in the assessment of moderate coronary lesions: a comparative study

1 Department of Cardiology, National Heart Institute, Cairo, Egypt
2 Cardiology Department of Cardiology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
3 Department of Cardiology, Menoufia University, Shebin El-Kom, Nasser Institute Hospital, Egypt

Correspondence Address:
Hazem Khamis
Waley El Ahd St., Hadayek El Koba, 11331 Cairo
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-2098.163891

Rights and Permissions

Objective The aim of this study was to assess intermediate coronary lesions as detected by visual estimation in coronary angiography using two invasive modalities: fractional flow reserve (FFR) and intravascular ultrasound. Background The significance of coronary artery stenosis of intermediate severity can be difficult to determine. The management of intermediate coronary lesions, defined by a diameter stenosis of more than 40% to less than 70%, continues to be a therapeutic dilemma for cardiologists. The two-dimensional representation of the arterial lesion provided by angiography is limited in distinguishing intermediate lesions that require stenting from those that simply need appropriate medical therapy. Patients and methods Thirty patients with intermediate coronary stenosis on coronary angiography were subjected to a noninvasive stress test, either exercise myocardial perfusion imaging or stress echocardiography, and the results were compared with those of intravascular ultrasound and FFR. Results In this study, 30 patients were subjected to FFR measurement. Twelve of 14 patients had an FFR of less than 0.80; reversible ischemia was detected on the stress test. In contrast, only two of 16 patients with an FFR of more than 0.80 had a negative stress test for reversible myocardial ischemia. FFR value has a sensitivity and a specificity of 85.7 and 87.5%, respectively, in predicting the results of a noninvasive stress test, with a positive predictive value and negative predictive value of 85.7 and 87.5%, respectively, with an accuracy of 86.7%. It is also showed that the best cutoff value for the minimal luminal area that is concordant with FFR values is less than 4.5 mm 2 , which has a sensitivity and a specificity of 57.1 and 56.3%, respectively, and positive predictive value of 53.3% and negative predictive value of 60%. Conclusion In patients with coronary stenosis of intermediate severity, FFR appears to be a useful index for assessment of the functional severity of coronary artery stenosis in comparison with a noninvasive stress test and can be used as a guide before coronary revascularization.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded87    
    Comments [Add]    

Recommend this journal