Impact of right atrial pressure on fractional flow reserve calculation in the presence of a chronic total occlusion.
Cardiovasc Revasc Med
; 19(6): 679-684, 2018 09.
Article
in En
| MEDLINE
| ID: mdl-29501432
BACKGROUND: The aim of this study was to assess the impact of right atrial pressure (Pra) on non-CTO vessels FFR measurements in patients with a chronic total occlusion. METHODS: Consecutive patients who underwent PCI for a CTO of the right coronary artery (RCA) were included. Prior to RCA recanalization, FFR and FFRmyo were measured in non-CTO vessels. FFR was calculated using the Pd/Pa equation during maximum hyperaemia and also accounting for right atrial pressure (Pd-Pra/Pa-Pra). Non-CTO vessels were characterised as major or minor donors based on angiographic assessment of provided collaterals. RESULTS: FFR and FFRmyo were measured in 68 arteries (34 LAD and 34 Cx) in 34 consecutive patients with successful RCA CTO PCI. Patients' mean age was 62⯱â¯10â¯years old and 88% were male. Mean left ventricular ejection fraction was 51%⯱â¯20. During maximum hyperaemia, mean Pra, Pa, and Pd were 4.1⯱â¯3.8â¯mmâ¯Hg, 82.6⯱â¯12.2â¯mmâ¯Hg, and 63.8⯱â¯14.3â¯mmâ¯Hg, respectively. In the major donor vessel, FFRmyo showed a difference of 0.007 to FFR (0.760⯱â¯0.113 vs. 0.767⯱â¯0.112, pâ¯=â¯0.004). In the minor donor vessel the difference was 0.004 (0.895⯱â¯0.067 vs. 0.899⯱â¯0.065, pâ¯<â¯0.001). There was a strong positive correlation between the FFR and FFRmyo in both the major and minor donor vessel groups (râ¯=â¯0.993, pâ¯<â¯0.001 and râ¯=â¯0.996, pâ¯<â¯0.001 respectively). CONCLUSION: In the presence of a CTO, RA pressure adjustment of FFR in the non-CTO vessels leads to trivial numerical changes, which are statistically significant but clinically negligible.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cardiac Catheterization
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Atrial Function, Right
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Coronary Vessels
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Fractional Flow Reserve, Myocardial
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Coronary Occlusion
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Angina, Stable
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Atrial Pressure
Type of study:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limits:
Aged
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
Cardiovasc Revasc Med
Year:
2018
Document type:
Article