Prediction of the physiologic severity of coronary lesions using 3D IVUS: validation by direct coronary pressure measurements.
This study was performed to determine whether three-dimensional intravascular ultrasound (3D IVUS) could predict the physiologic significance of coronary lesions. Seventeen lesions were evaluated by means of 3D IVUS, pressure measurements, and quantitative coronary angiography. Physiologic parameters were calculated from the 3D IVUS measures using established equations and compared to values measured by pressure guidewire. IVUS minimum lumen area (MLA) correlated with fractional flow reserve (FFR; R2 = 0.55, P = 0.003) and pressure gradient (R2 = 0.52, P = 0.003). Lesion length (L) had a positive correlation with pressure gradient (R2 = 0.45, P = 0.007). By multivariate analysis, the only significant independent determinant of FFR was MLA/L measured by IVUS. The IVUS-predicted pressure gradient and FFR were well correlated with values measured directly (R2) = 0.88, P < 0.001; R2 = 0.90, P < 0.001, respectively). The physiologic severity of coronary lesions is primarily influenced by lumen area and lesion length and can be established by 3D IVUS.
Takayama
T
T
Heart and Vascular Center, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
Hodgson
J M
JM
D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012720:Severity of Illness Index; D018084:Ultrasonography, Interventional / Q000379:methods; D017725:Ventricular Pressure / Q000502:physiology