[Angiographically marginally significant coronary stenoses--postponement of intervention based on measurement of myocardial fractional flow reserve].
BACKGROUND
When evaluating angiographically marginal coronary stenoses (i.e. 40-70% reduction of the diameter of the arterial lumen) it is under certain conditions difficult to decide on their actual functional impact. Assessment of the fractional flow reserve (FFR) is a simple method based on assessment of intracoronary pressures during pharmacologically induced hyperaemia. For the severity of stenosis according to previous studies the liminal values is FFR lower than 0.75; furthermore it was proved that intervention of angiographically marginal stenoses with FFR values of 0.75 or more can be safely postponed.


OBJECTIVE
Test the safety of FFR examination and take in a group of patients with marginally severe stenosis further steps according to results of FFR assessment.


METHODS
During the period from January to Juky 2000 FFR assessments were made in a total of 34 patients (11 women, 23 men, mean age 62 +/- 12 years) who suffered from marginal stenosis of some coronary vessel. The FFR examination took place under pharmacologically induced hyperaemia after intracoronary adenosine administration.


RESULTS
Measurements were made in a total of 41 stenoses. Only in two a value lower than 0.75 was found. In these patients coronary intervention was implemented; intervention was also made in two patients on account of technical problems and inconsistent results of FFR measurements. A FFR value of 0.75 or less was found in 37 stenoses (90%) and intervention was therefore postponed. Examination and the immediate subsequent course were without complications.


CONCLUSIONS
According to initial experience FFR examination is a safe, simple and easily reproducible method. Based on the results of assessment and knowledge of the accomplished studies in the group of marginally significant stenoses in a great proportion of patients coronary intervention was postponed.
Mates
M
M
Divize kardiologie Interní kliniky 2. lékarské fakulty UK, Praha.
Hrabos
V
V
Vojácek
J
J
Hájek
P
P
Malý
M
M
Horák
D
D
Fiedler
J
J
Durdil
V
V
D017023:Coronary Angiography; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D008875:Middle Aged
Angiograficky hranicnĕ významné koronární stenózy--odlození intervence na základĕ mĕrení frakcní průtokové rezervy myokardu.