title: The influence of side branch stenosis on fractional flow reserve assessment of the main branch in a swine model.
abstract: OBJECTIVE
  The aim of this study was to explore the effect of one stenosis in a daughter artery on the fractional flow reserve (FFR) of another stenosis parallels in side branch.
  
  
  BACKGROUND
  The impact of one stenosis on the FFR of another parallel stenosis has not been evaluated.
  
  
  METHODS
  The proximal segments of the left anterior descending (LAD) and left circumflex (LCX) arteries were exposed and encircled with a Teflon pledget complex in seven swine (55-70 kg). Five degrees of stenosis (to approximate angiographic diameter stenoses of 0%, 25%, 50%, 75%, and 100%) were made by tightening the pledgets. FFR was evaluated simultaneously in the LAD and the LCX with two pressure wires in each coronary artery. A mixed-effects linear model was used to evaluate the association between the FFR values.
  
  
  RESULTS
  A total of 115 paired FFR values were obtained. The FFR of the LAD and LCX were not significantly associated with each other (F = 0.237 and P = 0.627 for the LCX FFR to predict the LAD FFR; F = 0.541 and P = 0.463 for the LAD FFR to predict the LCX FFR).
  
  
  CONCLUSIONS
  The individual FFR values of each parallel stenosis in the LAD and the LCX were not significantly influenced by each other. This relationship was independent of the mean aortic pressure and heart rate. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Cardiology, Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Jun-Hyok
authors.initials: JH
authors.lastname: Oh
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Seunghwan
authors.initials: S
authors.lastname: Song
authors.affiliation: Department of Preventive Medicine, Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Changhoon
authors.initials: C
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine Cardiovascular Center, Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: Jeongsu
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Jin
authors.initials: J
authors.lastname: Sup Park
authors.affiliation: Department of Cardiology, Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Hye
authors.initials: H
authors.lastname: Won Lee
authors.affiliation: Department of Cardiology, Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Jung
authors.initials: J
authors.lastname: Hyun Choi
authors.affiliation: Department of Cardiology, Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Han
authors.initials: H
authors.lastname: Cheol Lee
authors.affiliation: Department of Cardiology, Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Kwang
authors.initials: K
authors.lastname: Soo Cha
authors.affiliation: Department of Cardiology, Medical Research Institute, Pusan National University Hospital, Busan, South Korea.
authors.forename: Taek
authors.initials: T
authors.lastname: Jong Hong
mesh_terms: D000818:Animals; D001011:Aorta / Q000503:physiopathology; D062186:Arterial Pressure; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004195:Disease Models, Animal; D053805:Fractional Flow Reserve, Myocardial; D006339:Heart Rate; D016014:Linear Models; D008297:Male; D008955:Models, Cardiovascular; D015999:Multivariate Analysis; D012720:Severity of Illness Index; D013552:Swine
keywords: fractional flow reserve; multivessel coronary artery disease; swine