title: Comparative Study between Perfusion Changes and Positive Findings on Coronary Flow Reserve.
abstract: BACKGROUND
  Functional assessment of coronary artery obstruction is used in cardiology practice to correlate anatomic obstructions with flow decrease. Among such assessments, the study of the coronary fractional flow reserve (FFR) has become the most widely used.
  
  
  OBJECTIVE
  To evaluate the correlation between FFR and findings of ischemia obtained by noninvasive methods including stress echocardiography and nuclear medicine and the presence of critical coronary artery obstruction.
  
  
  METHODS
  Retrospective study of cases treated with systematized and standardized procedures for coronary disease between March 2011 and August 2014. We included 96 patients with 107 critical coronary obstructions (> 50% in the coronary trunk and/or ≥ 70% in other segments) estimated by quantitative coronary angiography (QCA) and intracoronary ultrasound (ICUS). All cases presented ischemia in one of the noninvasive studies.
  
  
  RESULTS
  All 96 patients presented ischemia (100%) in one of the functional tests. On FFR study with adenosine 140 g/kg/min, 52% of the cases had values ≤ 0.80. On correlation analysis for FFR ≤ 0.80, the evaluation of sensitivity, specificity, positive and negative predictive values, accuracy, and ROC curve in relation to the stenosis degree and length, and presence of ischemia, no significant values or strong correlation were observed.
  
  
  CONCLUSIONS
  Coronary FFR using a cut-off value of 0.80 showed no correlation with noninvasive ischemia tests in patients with severe coronary artery obstructions on QCA and ICUS.
authors.affiliation: Hospital Cardiológico Costantini, Curitiba, PR, Brazil.
authors.forename: Costantino Roberto Frack
authors.initials: CR
authors.lastname: Costantini
authors.affiliation: Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Ramires
authors.affiliation: Hospital Cardiológico Costantini, Curitiba, PR, Brazil.
authors.forename: Costantino Ortiz
authors.initials: CO
authors.lastname: Costantini
authors.affiliation: Hospital Cardiológico Costantini, Curitiba, PR, Brazil.
authors.forename: Marcos Antonio
authors.initials: MA
authors.lastname: Denk
authors.affiliation: Hospital Cardiológico Costantini, Curitiba, PR, Brazil.
authors.forename: Sergio Gustavo
authors.initials: SG
authors.lastname: Tarbine
authors.affiliation: Hospital Cardiológico Costantini, Curitiba, PR, Brazil.
authors.forename: Marcelo de Freitas
authors.initials: MF
authors.lastname: Santos
authors.affiliation: Hospital Cardiológico Costantini, Curitiba, PR, Brazil.
authors.forename: Daniel Aníbal
authors.initials: DA
authors.lastname: Zanuttini
authors.affiliation: Hospital Cardiológico Costantini, Curitiba, PR, Brazil.
authors.forename: Carmen Weigert
authors.initials: CW
authors.lastname: Silveira
authors.affiliation: Hospital Cardiológico Costantini, Curitiba, PR, Brazil.
authors.forename: Admar Moraes de
authors.initials: AM
authors.lastname: Souza
authors.affiliation: Hospital Cardiológico Costantini, Curitiba, PR, Brazil.
authors.forename: Rafael Michel de
authors.initials: RM
authors.lastname: Macedo
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D002932:Cineangiography / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D003331:Coronary Vessels / Q000503:physiopathology; D025401:Echocardiography, Stress / Q000379:methods; D005260:Female; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric