CORONARY ARTERY DISEASE (CAD);

Abstract

Background: Coronary artery lesion severity is physiological assessed byfractional myocardial flow reserve (FFR). Angiographic assessment of intermediate severitylesions is problematic as inter-observer variability is significant. Hence one is not sure aboutthe hemodynamic or functional significance of these lesions. FFR is helpful in this situationby assessing functional or hemodynamic significance of these intermediate coronary lesions.An FFR value <0.80 identifies ischemia-causing coronary stenosis with an accuracy of >90%suggesting that intermediate coronary lesion is in fact functionally important. Objective: Todetermine the correlation between mean lesion length of diffuse intermediate stenosis (40%-70% stenosis) of proximal and mid segment of major coronary arteries and mean fractional flowreserve (FFR). Study duration: From 1-07-2015 to 31-12-2015. Study design: Cross sectionalstudy. Methodology: After approval from hospital Ethical committee and Informed consent, 60patients with intermediate diffuse lesions on coronary angiography from Faisalabad Institute ofCardiology were enrolled. FFR assessment of diffuse intermediate lesion was done by author.FFR assessment was done using FFR wire during maximal blood flow (hyperemia) whichwas induced by injecting bolus dose of intracoronary adenosine. The cost of procedure wasmanaged by hospital. Results: In this study, 28.33% (n=17) were between 20-50 years of age,mean+SD was calculated as 55.17+8.04 years, 51.67% (n=31) were male and 48.33% (n=29)were females. Correlation between mean lesion length of diffuse intermediate stenosis (40%-70% stenosis) of proximal and mid segment of major coronary arteries and mean fractionalflow reserve (FFR) was recorded it shows that mean lesion length was 24.53+4.78 mm whileFFR was recorded as 0.72+0.12, the value of R is -0.1928, technically a negative correlation,the relationship between variables is only weak (the nearer the value is to zero, the weakerthe relationship). The value of R2, the coefficient of determination, is 0.0372. Conclusion: Thecorrelation between mean lesion length of diffuse intermediate stenosis (40%-70% stenosis) ofproximal and mid segment of major coronary arteries and mean fractional flow reserve (FFR)was weak and did not suggest any hemodynamic significance of diffuse intermediate coronaryartery lesions.