title: Diagnostic accuracy of quantitative angiographic and intravascular ultrasound parameters predicting the functional significance of single de novo lesions.
abstract: OBJECTIVE
  The current study aimed at determining the best cutoff value of angiographic and intravascular ultrasound (IVUS) parameters for defining fractional flow reserve (FFR) <0.8 in patients with single coronary artery lesion.
  
  
  BACKGROUND
  The correlation between angiographic or IVUS variables and FFR in patients with single coronary artery lesions has not been studied yet.
  
  
  METHODS
  Quantitative coronary analysis and IVUS and FFR measurements were used in 323 patients with a single lesion. The best angiographic and IVUS cutoff values and their predictive value for FFR<0.8 were compared using area under the receiver-operator characteristic curve (AUC).
  
  
  RESULTS
  FFR<0.8 was in 54.2%. Minimal lumen area (MLA), plaque burden (PB), lesion length (LL) and lesion at left anterior descending artery (LAD) were four predictors of FFR<0.8. LL had less value in predicting FFR<0.8. The cutoff values of PB and MLA for FFR<0.8 were 72.7% and 2.97 mm(2). MLA and PB had similar high diagnostic value for vessel size ≥ 3 mm (cutoff values: 3.02 mm(2) and 80.7%), proximal LAD lesion (cutoff values: 3.04 mm(2) and 76.5%) and unstable angina (2.82 mm(2) and 71.9%). Combination of MLA (2.82 mm(2)) and PB (80.6%) had increased diagnostic value for distal LAD lesion. Only PB (71%) had higher diagnostic value for diabetic patients. MLA and PB could not predict FFR<0.8 for vessel size<3mm, and non-LAD lesion.
  
  
  CONCLUSIONS
  Best cutoff value of MLA and PB for FFR<0.8 in patients with a single lesion is patient-, vessel size- and lesion location-oriented. PB has strengthened diagnostic accuracy for diabetic patients.
authors.affiliation: Nanjing First Hospital, Nanjing Medical University, Nanjing, China. Electronic address: chmengx@126.com.
authors.forename: Shao-Liang
authors.initials: SL
authors.lastname: Chen
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
authors.forename: Jack B
authors.initials: JB
authors.lastname: Chen
authors.forename: Tian
authors.initials: T
authors.lastname: Xu
authors.forename: Fei
authors.initials: F
authors.lastname: Ye
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Zhang
authors.forename: Tak W
authors.initials: TW
authors.lastname: Kwan
authors.forename: Nai-Liang
authors.initials: NL
authors.lastname: Tian
authors.forename: Zhi-Zhong
authors.initials: ZZ
authors.lastname: Liu
authors.forename: Song
authors.initials: S
authors.lastname: Lin
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000592:standards*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012042:Registries; D018084:Ultrasonography, Interventional / Q000592:standards*