title: Influence of plaque characteristics on fractional flow reserve for coronary lesions with intermediate to obstructive stenosis: insights from integrated-backscatter intravascular ultrasound analysis.
abstract: The aim of this study was to determine the correlation between the fractional flow reserve (FFR) values and volumetric intravascular ultrasound (IVUS) parameters derived from classic gray-scale IVUS and integrated backscatter (IB)-IVUS, taking into account known confounding factors. Patients with unstable angina pectoris with the frequent development of vulnerable plaques often showed the discrepancy between the FFR value and the quantitative coronary angiography findings. Our target population was 107 consecutive subjects with 114 isolated lesions who were scheduled for elective coronary angiography. The FFR was calculated as the mean distal coronary pressure divided by the mean aortic pressure during maximal hyperemia. Various volumetric parameters such as lipid plaque volume (LPV) and percentage of LPV (%LPV) were measured using IB-IVUS. Simple and multivariate linear regression analysis was employed to evaluate the correlation between FFR values and various classic gray-scale IVUS and IB-IVUS parameters. The Akaike information criterion (AIC) was used to compare the goodness of fit in an each model. Both the %LPV (r = -0.24; p = 0.01) and LPV (r = -0.40; p < 0.01) were significantly correlated with the FFR value. Only the LPV (AIC = -147.0; p = 0.006) and %LPV (AIC = -152.9; p = 0.005) proved to be independent predictors for the FFR value even after the adjustment of known confounding factors. The volumetric assessment by IB-IVUS could provide better information in terms of the relationship between plaque morphology and the FFR values as compared to the classic IVUS 2-dimensional gray-scale analysis.
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Sakurai
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takashima
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Waseda
authors.affiliation: Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Gosho
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Kurita
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Ando
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.
authors.forename: Masanobu
authors.initials: M
authors.lastname: Fujimoto
authors.affiliation: Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan. amanot@aichi-med-u.ac.jp.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Amano
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D018084:Ultrasonography, Interventional
keywords: Fractional flow reserve; Integrated backscatter intravascular ultrasound; Plaque characteristics