Angiographic predictors of coronary hemodynamics

Future Cardiol. 2022 Apr;18(4):299-308. doi: 10.2217/fca-2020-0090. Epub 2022 Feb 22.

Abstract

Aims: Assess the correlation between diameter stenosis, lesion length, location, diffuse coronary disease and with fractional flow reserve (FFR). Methods/Results: We performed quantitative coronary analysis analysis on 384 lesions with stable coronary artery disease undergoing FFR assessment. Vessels were 59.1% left anterior descending artery (LAD), 16.1% left circumflex artery and 14.8% right coronary artery. Median diameter stenosis was 58% ± 2.5 and median lesion length was 10 mm ± 7.36. 21% of vessels were diffusely diseased. Lesions were 33.6% proximal, 44% mid-vessel and 12% distal. Median FFR was 0.85. Diameter stenosis correlated with lower FFR (p < 0.005, odds ratio [OR]: 2.4 [95% CI: 0.99-5.63]). There was no association between lesion length, location, number of proximal side branches and FFR. Vessels with diffuse disease had a nonsignificant trend for lower FFR (0.84 vs 0.85, p = 0.375, OR: 1.26 [95% CI: 0.76-2.09]). LAD lesions had significantly lower FFR compared with non-LAD (p < 0.001, OR: 2.55 [95% CI: 1.61-4.04]); including left circumflex artery and right coronary artery lesions (p = 0.001, OR: 3.4 [95% CI: 1.7-6.9]) and p = 0.02, OR: 2.55 [95% CI: 1.17-4.34]). Conclusion: FFR is not related to lesion length, location or number of proximal branches.

Keywords: FFR; coronary physiology; coronary stenosis; iFR; interventional cardiology.

MeSH terms

  • Cardiac Catheterization
  • Constriction, Pathologic
  • Coronary Angiography
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Stenosis* / diagnostic imaging
  • Coronary Vessels / diagnostic imaging
  • Fractional Flow Reserve, Myocardial*
  • Hemodynamics
  • Humans
  • Predictive Value of Tests
  • Severity of Illness Index