eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
3/2016
vol. 12
 
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abstract:
Original paper

Efficacy of coronary fractional flow reserve using contrast medium compared to adenosine

Selim Topcu, Ibrahim Halil Tanboğa, Enbiya Aksakal, Uğur Aksu, Oktay Gulcu, Oğuzhan Birdal, Arif Arısoy, Arzu Kalaycı, Fatih Rifat Ulusoy, Serdar Sevimli

Adv Interv Cardiol 2016; 12, 3 (45): 212–216
Online publish date: 2016/08/19
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Aim: To compare the contrast medium induced Pd/Pa ratio (CMR) with the FFR.

Material and methods: We enrolled 28 consecutive patients with 34 intermediate lesions who underwent coronary FFR measurement by intracoronary (i.c.) adenosine. After baseline Pd/Pa was calculated, a single contrast medium (Iomeron) injection of 6 ml (3 ml/s) was performed manually. Within 10 s after the contrast medium injection, the CMR was calculated. Bolus injection of i.c. adenosine was performed to induce maximal hyperemia (from 60 µg to 600 µg), and when it was ≤ 0.80, the intermediate lesion was considered as significant.

Results: After bolus i.c. adenosine, 12 lesions of 34 (35.3%) were identified as significant. The CMR value was 0.86 ±0.06 (range: 0.71–0.97). There were no significant differences between FFR and CMR values (p = 0.108). A substantial positive correlation between adenosine and contrast values was detected (0.886 and p < 0.001). Good agreement in Bland-Altman analysis was revealed (mean bias was 0.027, 95% confidence interval 0.038–0.092). Receiver operating characteristics curve analysis showed 90.9% sensitivity and 91.7% specificity for a cut-off value of 0.85 for the CMR compared to FFR (≤ 0.80).

Conclusions: Our study showed that measuring the CMR is a feasible method compared to FFR. The CMR may be used in situations where adenosine cannot be administered.
keywords:

adenosine, fractional flow reserve, contrast medium

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