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Resting Pd/Pa measured with intracoronary pressure wire strongly predicts fractional flow reserve.

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Academic year: 2021

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Resting Pd/Pa measured with intracoronary pressure

wire strongly predicts fractional flow reserve.

Abstract

OBJECTIVE:

To investigate the relationship between resting distal coronary pressure to aortic pressure ratio (Pd/Pa) and fractional flow reserve (FFR) obtained during maximal hyperemia.

BACKGROUND:

FFR is an invasive index of the functional severity of a coronary artery stenosis determined from coronary pressure measurements. It is generally believed that there is little correlation between resting Pd/Pa and FFR obtained during maximal hyperemia. We have therefore studied this relationship in a large cohort of patients who had undergone pressure- wire assessments.

METHODS:

528 consecutive pressure-wire studies performed in 483 patients over a 2-year period were retrospectively analyzed.

RESULTS:

A linear correlation between resting Pd/Pa and FFR post-pharmacological hyperemia was observed (rho = 0.74; p < 0.0001). When a FFR of < or = 0.75 (or < or = 0.80 as per FAME) was defined as positive, a resting Pd/Pa of < or = 0.85 (< or = 0.87) had a positive predictive value (PPV) of 95% (94.6%), while a resting Pd/Pa of > or = 0.93 (> or = 0.96) had a negative predictive value (NPV) of 95.7% (93%).

CONCLUSIONS:

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