The Correlation Of Critical Coronary In-stent Restenosis Lesions Quantitative Coronary Angiography Parameter And Fractional Flow Reserve

Objective1.To study the correlation between two-dimensional quantitative coronaryangiography (QCA) analysis measurements of coronary in-stent restenosis (ISR) lesionscritical indicators (lesion percent diameter stenosis, minimal lumen diameter,etc) andfractional flow reserve (FFR).2. With FFR as a “gold standard”from the QCA analysis ofthe indicators measuring ISR critical lesions (lesion percent diameter stenosis, minimallumen diameter, etc.) screened ideal evaluation of myocardial ischemia radiographicparameters. Methods1.A total of21patients,26critical ISR lesions, mean age(66.96±9.10) years old. Divided into two groups according to the value of FFR, FFR≥0.8(n=16) group and FFR <0.80Group (lesion n=10), all lesions were rows QCA andFFR measurements acquire the reference vessel diameter (RVD), reference vessel area(RVA), minimal lumen diameter opening (MLD), minimal lumen open area (MLA),lesion percent diameter stenosis (RS%), lesion length (LL) and FFR values.2.Usingcorrelation analysis and calculation RVD, RVA, MLD, MLA, RS%and LL and thecorrelation between FFR values. With FFR≥0.8is bounded values, using receiveroperating characteristic (ROC) curve analysis QCA measurement parameters aretruncated anatomy. Results1. A total of21patients26critical ISR lesions completedQCA and FFR measurements,16cases for single-vessel disease, five cases for double-vessel disease,0cases for three lesions,17for the left anterior descending artery lesions,4for circumflex artery disease,3for the right coronary artery,1for intermediate lesions,1for the diagonal artery disease, QCA measurements DS%average of (54±11)%, MLDmean (1.21±0.38) mm, FFR mean value (0.82±0.11), where the minimum FFR0.62,the maximum FFR0.96,10lesions (38%) lower limit (FFR <0.80).2. Two lesions in thepercent diameter stenosis [RS%,(52±12)%vs.(60±7)%, P=0.03] were statisticallysignificant differences, and in length [LL,(6.83±3.69) mm vs.(9.66±3.56) mm, P=0.066], reference vessel diameter [RVD,(2.65±0.50) mm vs.(2.64±0.64) mm, P=0.951], reference vessel area [RVA,(5.70±2.18) mm2vs.(5.70±2.18) mm2, P=0.962],minimal lumen diameter opening [MLD,(1.31±0.42) mm vs.(1.04±0.26) mm, P= 0.081] and minimal lumen open area [MLA,(1.49±1.14) mm2vs.(0.87±0.41) mm2, P=0.112] showed no statistical difference. RVD, RVA and LL no correlation with FFR (r=0.012,-0.019and-0.012, P values were0.954,0.927and0.954). MLA, MLD andDS%and FFR showed different degrees of correlation (r=0.46,0.491and-0.567, Pvalues were0.018,0.011and0.003), with DS%strongest correlation with FFR. WithFFR≥0.80as the limit value, drawing on the DS%of the ROC curve, area under thecurve (areas under the curve, AUC) was0.703(P=0.003). DS%smaller lesions inducedmyocardial ischemia less likely. DS%<57%as a cut-off point to predict non-functionalsignificance of lesions (FFR≥0.80) sensitivity=70%, specificity=62.5%, positivepredictive value=53.84%, negative predictive value=76.92%.Conclusions In criticalcoronary in-stent restenosis lesions, MLA, MLD and DS%with FFR value exists somecorrelation, in which DS%can be more accurately predict coronary in-stent restenosislesions critical flow reserve functional significance.