title: Prediction of Fractional Flow Reserve without Hyperemic Induction Based on Resting Baseline Pd/Pa.
abstract: OBJECTIVE
  The purposes of this study are 1) to investigate the relationship between resting baseline Pd/Pa, determined by the ratio of the pressures proximal (Pa) and distal (Pd) to the target lesion before, inducing hyperemia and fractional flow reserve (FFR) and 2) to identify a resting baseline Pd/Pa range that might reliably preclude the need for hyperemic induction.
  
  
  METHODS
  A total of 622 pressure wire data sets obtained from intermediate stenotic lesions were analyzed.
  
  
  RESULTS
  There was a good linear relationship between resting baseline Pd/Pa and FFR (r=0.746, p<0.001). Receiver-operating characteristic curves of the resting baseline Pd/Pa with FFR ≤0.80 as the reference variable showed an area under the curve of 0.89 (95% confidence intervals 0.863-0.914, p<0.001) with a diagnostic accuracy of 82.3% when the resting baseline Pd/Pa was ≤0.92. These results showed that certain cutoff values can reliably predict FFR, whether positive or negative. The resting baseline Pd/Pa >0.95 (n=257, 41.3%) had a negative predictive value (NPV) of 98.1% and a sensitivity of 97.3%. the resting baseline Pd/Pa ≤0.88 (n=65, 10.5%) had a positive predictive value (PPV) of 96.2% and a specificity of 99.8%. These were consistent regardless of coronary vessel, lesion location, lesion length, or degree of stenosis.
  
  
  CONCLUSIONS
  In intermediate lesions, the resting baseline Pd/Pa was linearly related to FFR. A certain range of the resting baseline Pd/Pa values had an excellent NPV with high sensitivity or excellent PPV with high specificity for determining the lesion significance.
authors.affiliation: Division of Cardiology, Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
authors.forename: Jeong Su
authors.initials: JS
authors.lastname: Kim
authors.forename: Heon Deok
authors.initials: HD
authors.lastname: Lee
authors.forename: Yong Kweon
authors.initials: YK
authors.lastname: Suh
authors.forename: June Hong
authors.initials: JH
authors.lastname: Kim
authors.forename: Kook Jin
authors.initials: KJ
authors.lastname: Chun
authors.forename: Yong Hyun
authors.initials: YH
authors.lastname: Park
authors.forename: Jun
authors.initials: J
authors.lastname: Kim
authors.forename: Dong Cheul
authors.initials: DC
authors.lastname: Han
authors.forename: Chang Bae
authors.initials: CB
authors.lastname: Sohn
keywords: Cardiovascular physiological phenomana; Fractional flow reserve, myocardial