title: Impact of lesion length on functional significance in intermediate coronary lesions.
abstract: BACKGROUND
  Myocardial fractional flow reserve (FFR) is useful in the evaluation of coronary lesion ischemia. However, the impact of lesion length on FFR has not been adequately assessed.
  
  
  OBJECTIVE
  We hypothesized that lesion length would influence functional significance in intermediate coronary lesions.
  
  
  METHODS
  FFR measurements were assessed in 136 patients (163 lesions) with stable angina who had >40% stenotic coronary lesion by quantitative coronary angiography (QCA). One hundred sixty-three lesions were classified as intermediate (40%-70% stenosis; n=107; group I) or significant (≥70%; n=56; group S) by QCA. We assessed the relationships between lesion length, coronary stenosis, and FFR in these 163 lesions.
  
  
  RESULTS
  Regression analysis revealed an inverse correlation between the percentage of diameter stenosis (%DS) and FFR in group S (r = -0.83, P < 0.0001). In group I, no significant correlation was found between %DS and FFR (r = -0.06, P = 0.55), whereas lesion length was significantly inversely correlated with FFR (r = -0.79, P < 0.0001). Receiver operating characteristic curve analysis demonstrated that the best cutoff value for predicting an FFR value <0.80 was a lesion length >16.1 mm in group I (sensitivity, 86%; specificity, 94%).
  
  
  CONCLUSIONS
  These study findings suggest that lesion length has a physiologically significant impact on intermediate-grade coronary lesions.
authors.affiliation: Department of Internal Medicine and Cardiology, Graduate School of Medicine, Osaka City University, Osaka, Japan. t.igu74@gmail.com
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Iguchi
authors.forename: Takao
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishimura
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakata
authors.forename: Toru
authors.initials: T
authors.lastname: Kataoka
authors.forename: Shoichi
authors.initials: S
authors.lastname: Ehara
authors.forename: Akihisa
authors.initials: A
authors.lastname: Hanatani
authors.forename: Kenei
authors.initials: K
authors.lastname: Shimada
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000175:diagnosis / Q000503:physiopathology; D006328:Cardiac Catheterization; 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; D011237:Predictive Value of Tests; D012372:ROC Curve; D012044:Regression Analysis; D012720:Severity of Illness Index