The reliability of fractional flow reserve measurement in patients with diabetes mellitus.
BACKGROUND
Fractional flow reserve (FFR) is an invasive method to assess the functional significance of coronary stenoses. The value of FFR in diabetic patients is controversial because of microvascular dysfunction. The aim of this study is to investigate the effect of diabetes mellitus (DM) on FFR measurements.


METHODS
One hundred and twenty-one patients with an intermediate lesion who had undergone FFR measurement were included in the study. Lesion severity was determined by quantitative coronary angiography. The patients were divided into groups according to the presence (group 1) or absence (group 2) of DM. The patients were further categorized according to the degree of luminal narrowing caused by the lesion (40-50, 51-60, and >60%) and reference vessel diameter (> or = 2.8 and <2.8 mm). FFR measurements were compared in each category.


RESULTS
There was no difference between the FFR values of diabetic and nondiabetic patients who had coronary lesions with similar degree of luminal narrowing (0.87+/-0.08 vs. 0. 0.85+/-0.07; 0.81+/-0.08 vs. 0.82+/-0.10; 0.81+/-0.10 vs. 0.83+/-0.09, P = 0.957). In the analysis comparing FFR measurements in the categories set according to reference vessel diameter, we did not find a difference either (0.82+/-0.09 vs. 0.83+/-0.09; 0.84+/-0.09 vs. 0.82+/-0.09, P = 0.878). The DeltaFFR value, which is the difference between FFR values before and after adenosine administration, was also similar in diabetic and nondiabetic patients (8.4+/-6.0 vs. 8.4+/-5.5, P = 0.997).


CONCLUSIONS
The presence of DM does not have a significant impact on FFR values in coronary stenoses of intermediate severity.
Sahinarslan
Asife
A
Department of Cardiology, School of Medicine, Gazi University, Ankara 06500, Turkey. asifesah@yahoo.com
Kocaman
Sinan Altan
SA
Olgun
Hilal
H
Kunak
Tolga
T
Kiziltunç
Emrullah
E
Ozdemir
Murat
M
Timurkaynak
Timur
T
D000241:Adenosine; D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis / Q000503:physiopathology*; D003920:Diabetes Mellitus / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000503:physiopathology*; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index
D000241:Adenosine