Impact of metabolic syndrome on fractional flow reserve

Abstract

Objective Fractional fl ow reserve (FFR) assessment is widely used to determine signifi cance of intermediate coronary lesions. Previously, components of the metabolic syndrome (MS) which may aff ect FFR validity were not tested cumulatively. In this study, we investigate the possible eff ect of MS on FFR assessment.Methods and results We retrospectively evaluated 178 consecutive patients who had undergone FFR assessment. Thirty-two patients were excluded. All of the coronary lesions were in the left anterior descending artery. They were evaluated with quantitative coronary angiography (QCA). In 105 patients the MS was present and 41 patients were without the MS. According to the severity of the coronary lesions in QCA, patients were divided into three groups: 40-50%, 51-60% and 61-70% lesions. FFR measurements were compared in each group with respect to MS presence. Coronary artery lesions were accepted as haemodynamically signifi cant if FFR ≤ 0.80. Age of the population, lesion length, lesion diameter and adenosine dosage performed during FFR assessment were not diff erent between patients with MS or without MS. When the lesions were divided into three categories according to the severity of the luminal narrowing expressed in stenosis percentages as 40-50, 51-60, and more than 61%, the observed FFR values decreased with advancing lesion category (P = 0.04). However, observed FFR values did not diff er between the patients with MS and without MS in each category (P = 0.88). After exclusion of the diabetic patients, FFR values still did not diff er between the patients with MS and without MS in each category (P = 0.78).Conclusions Presence of the metabolic syndrome has no signifi cant eff ect on FFR assessment. This study provides additional data for the reliability of FFR in patients with MS.