The Role of Intravascular Ultrasound (IVUS) in Predicting the Functional Significance of the Intermediate Coronary Lesions in Correlation with Fractional Flow Reserve (FFR)

AHMED K. MOTAWIE, M.D., MAHMOUD RADWAN, M.Sc.;; AHMED MAGDY, M.D., MAMDOUH H. EL-TAHAN, M.D.;

doi:10.21608/mjcu.2018.57505

The Role of Intravascular Ultrasound (IVUS) in Predicting the Functional Significance of the Intermediate Coronary Lesions in Correlation with Fractional Flow Reserve (FFR)

Document Type : Original Article

Authors

The Department of Cardiology, National Heart Inistitute, Giza* and Al-Azhar Faculty of Medicine, Cairo**, Egypt

10.21608/mjcu.2018.57505

Abstract

Abstract
Background: It is necessary and of great benefit for the patients to improve diagnostic tools along with the technical development, and as Fraction Flow Reserve (FFR) is consid-ered the gold standard for assessing intermediate coronary lesions. This study aimed to further investigate the correlation between Fractional Flow Reserve (FFR) and Intravascular Ultrasound (IVUS) metrics including Minimal Lumen Area (MLA). Which remains a debatable issue in the assessment of intermediate coronary artery stenosis.
Methods: Thirty patients with thirty eight intermediate stenotic lesions located in the main coronary vessles, were assessed by FFR, IVUS and quantitative angiography. Receiver –Operating Characteristic (ROC) curve analyses were used to identify MLA best cut-off values predictive of FFR value less than 0.80.
Results: The best cut-off value for MLA which is con-cordant with ischemic FFR values is <3mm2 with a sensitivity and specificity 76.92% and 50% respectively, and a predictive values PPV=45% and NPV=80%.
Conclusion: MLA of intermediate coronary lesions ob-tained by IVUS showed a good correlation with FFR meas-urements [IVUS-MLA £3.0mm2 was the best cut off value for identifying FFR <0.8 in coronary vessels With a good negative predictive value of 80%].

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