title: Relationship between fractional flow reserve and angiographic and intravascular ultrasound parameters in ostial lesions: major epicardial vessel versus side branch ostial lesions.
abstract: OBJECTIVE
  This study sought to assess the relationship of coronary angiography, intravascular ultrasound (IVUS) and fractional flow reserve (FFR) between major epicardial vessel (MV) and side branch (SB) ostial lesions.
  
  
  BACKGROUND
  Evaluation of ostial lesions is clinically very important. However, anatomical parameters have limitations in the prediction of the functional significance of coronary stenoses.
  
  
  METHODS
  IVUS and FFR measurement were performed in 93 lesions (MV: 38, SB: 55). Optimal angiographic and IVUS criteria and their diagnostic accuracy for functionally significant stenoses (FFR ≤0.8) were assessed.
  
  
  RESULTS
  In MV ostial lesions, FFR had correlation with angiographic percent diameter stenosis (r = -0.68, p < 0.001), minimum lumen area (MLA) by IVUS (r = 0.55, p < 0.001), percent plaque burden (r = -0.42, p = 0.011), and percent area stenosis (r = -0.49, p = 0.003). Meanwhile, FFR had no correlation with angiographic percent diameter stenosis (r = -0.067, p = 0.635) and weak correlation with MLA (r = 0.30, p = 0.026) in SB ostial lesions. In MV ostial lesions, best cutoff value of angiographic percent diameter stenosis, MLA, percent plaque burden, and percent area stenosis to determine the functional significance was 53%, 3.5 mm(2), 70%, and 50%. However, a statistically significant cutoff value of percent diameter stenosis and MLA could not be found in SB ostial lesions.
  
  
  CONCLUSIONS
  The relations between angiographic/IVUS parameters and FFR were different between MV and SB ostial lesions. Angiographic and IVUS parameters had poor diagnostic accuracy in predicting the functional significance of SB ostial lesions. (Main Branch Versus Side Branch Ostial Lesion; NCT01335659).
authors.affiliation: Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jin-Sin
authors.initials: JS
authors.lastname: Koh
authors.forename: Bon-Kwon
authors.initials: BK
authors.lastname: Koo
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Han-Mo
authors.initials: HM
authors.lastname: Yang
authors.forename: Kyung-Woo
authors.initials: KW
authors.lastname: Park
authors.forename: Hyun-Jae
authors.initials: HJ
authors.lastname: Kang
authors.forename: Hyo-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Byung-Hee
authors.initials: BH
authors.lastname: Oh
authors.forename: Young-Bae
authors.initials: YB
authors.lastname: Park
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D011237:Predictive Value of Tests; D056910:Republic of Korea; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018084:Ultrasonography, Interventional