Correlation between frequency-domain optical coherence tomography and fractional flow reserve in angiographically-intermediate coronary lesions

Francesco Burzotta; Roberto Nerla; Jonathan Hill; Lazzaro Paraggio; Antonio Maria Leone; Jonathan Byrne; Italo Porto; Giampaolo Niccoli; Cristina Aurigemma; Carlo Trani; Philip MacCarthy; Filippo Crea

doi:10.1016/j.ijcard.2017.10.011

Correlation between frequency-domain optical coherence tomography and fractional flow reserve in angiographically-intermediate coronary lesions

Francesco Burzotta, Roberto Nerla, Jonathan Hill, Lazzaro Paraggio, Antonio Maria Leone, Jonathan Byrne, Italo Porto, Giampaolo Niccoli, Cristina Aurigemma, Carlo Trani, Philip MacCarthy, Filippo Crea

King's College London

Research output: Contribution to journal › Article › peer-review

24 Citations (Scopus)

Abstract

Background The decision-making process of patients with angiographically-intermediate coronary lesions (ICL) is clinically challenging and may benefit from adjunctive invasive techniques. Fractional-flow-reserve (FFR) represents the gold standard to evaluate ICL but frequency-domain optical-coherence-tomography (OCT) is a novel, promising, high resolution coronary imaging technique, which allows physiopathologic assessment of coronary plaque. We investigated the possible relation between OCT and FFR in selected ICL patients. Methods Stable or unstable patients with ICL who underwent both FFR and OCT assessment at two large tertiary centers were retrospectively enrolled. FFR was performed according to standard methodology. OCT images were (on blind to clinical and FFR results) analyzed to assess minimal lumen area (MLA), percentage area stenosis (AS), thrombus and plaque ulceration. Results Forty patients were identified (62 ± 10 years, 93% symptomatic, 35% acute presentation, 93% left-anterior-descending artery ICL). Percentage diameter stenosis at quantitative coronary angiography was 40 ± 12% and FFR was 0.85 ± 0.07. MLA (p = 0.009), AS (p < 0.001) and plaque ulceration (p = 0.02) were significantly associated with FFR values. An integrated assessment of AS (≥ or < 70%), MLA (≥ or < 2.5 mm2) and presence or absence of thrombus and plaque ulceration was found to have the potential to accurately (sensitivity 91%, specificity 93%) predict FFR results. Conclusion In patients with ICL, a combination of different OCT parameters may help predict FFR results. These findings suggest that only a comprehensive assessment of lesion features by OCT can allow an accurate prediction of lesion severity assessed by FFR.

Original language	English
Pages (from-to)	55-60
Number of pages	6
Journal	International Journal of Cardiology
Volume	253
Early online date	3 Jan 2018
DOIs	https://doi.org/10.1016/j.ijcard.2017.10.011
Publication status	Published - 15 Feb 2018

Keywords

Optical coherence tomography
Fractional flow reserve
Intermediate coronary lesions

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10.1016/j.ijcard.2017.10.011

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Burzotta, F., Nerla, R., Hill, J., Paraggio, L., Leone, A. M., Byrne, J., Porto, I., Niccoli, G., Aurigemma, C., Trani, C., MacCarthy, P., & Crea, F. (2018). Correlation between frequency-domain optical coherence tomography and fractional flow reserve in angiographically-intermediate coronary lesions. International Journal of Cardiology, 253, 55-60. https://doi.org/10.1016/j.ijcard.2017.10.011

@article{54a9e31d19564b2cb757749db5dc30e7,

title = "Correlation between frequency-domain optical coherence tomography and fractional flow reserve in angiographically-intermediate coronary lesions",

abstract = "Background The decision-making process of patients with angiographically-intermediate coronary lesions (ICL) is clinically challenging and may benefit from adjunctive invasive techniques. Fractional-flow-reserve (FFR) represents the gold standard to evaluate ICL but frequency-domain optical-coherence-tomography (OCT) is a novel, promising, high resolution coronary imaging technique, which allows physiopathologic assessment of coronary plaque. We investigated the possible relation between OCT and FFR in selected ICL patients. Methods Stable or unstable patients with ICL who underwent both FFR and OCT assessment at two large tertiary centers were retrospectively enrolled. FFR was performed according to standard methodology. OCT images were (on blind to clinical and FFR results) analyzed to assess minimal lumen area (MLA), percentage area stenosis (AS), thrombus and plaque ulceration. Results Forty patients were identified (62 ± 10 years, 93% symptomatic, 35% acute presentation, 93% left-anterior-descending artery ICL). Percentage diameter stenosis at quantitative coronary angiography was 40 ± 12% and FFR was 0.85 ± 0.07. MLA (p = 0.009), AS (p < 0.001) and plaque ulceration (p = 0.02) were significantly associated with FFR values. An integrated assessment of AS (≥ or < 70%), MLA (≥ or < 2.5 mm2) and presence or absence of thrombus and plaque ulceration was found to have the potential to accurately (sensitivity 91%, specificity 93%) predict FFR results. Conclusion In patients with ICL, a combination of different OCT parameters may help predict FFR results. These findings suggest that only a comprehensive assessment of lesion features by OCT can allow an accurate prediction of lesion severity assessed by FFR.",

keywords = "Optical coherence tomography, Fractional flow reserve, Intermediate coronary lesions",

author = "Francesco Burzotta and Roberto Nerla and Jonathan Hill and Lazzaro Paraggio and Leone, {Antonio Maria} and Jonathan Byrne and Italo Porto and Giampaolo Niccoli and Cristina Aurigemma and Carlo Trani and Philip MacCarthy and Filippo Crea",

year = "2018",

month = feb,

day = "15",

doi = "10.1016/j.ijcard.2017.10.011",

language = "English",

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pages = "55--60",

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Burzotta, F, Nerla, R, Hill, J, Paraggio, L, Leone, AM, Byrne, J, Porto, I, Niccoli, G, Aurigemma, C, Trani, C, MacCarthy, P & Crea, F 2018, 'Correlation between frequency-domain optical coherence tomography and fractional flow reserve in angiographically-intermediate coronary lesions', International Journal of Cardiology, vol. 253, pp. 55-60. https://doi.org/10.1016/j.ijcard.2017.10.011

TY - JOUR

T1 - Correlation between frequency-domain optical coherence tomography and fractional flow reserve in angiographically-intermediate coronary lesions

AU - Burzotta, Francesco

AU - Nerla, Roberto

AU - Hill, Jonathan

AU - Paraggio, Lazzaro

AU - Leone, Antonio Maria

AU - Byrne, Jonathan

AU - Porto, Italo

AU - Niccoli, Giampaolo

AU - Aurigemma, Cristina

AU - Trani, Carlo

AU - MacCarthy, Philip

AU - Crea, Filippo

PY - 2018/2/15

Y1 - 2018/2/15

N2 - Background The decision-making process of patients with angiographically-intermediate coronary lesions (ICL) is clinically challenging and may benefit from adjunctive invasive techniques. Fractional-flow-reserve (FFR) represents the gold standard to evaluate ICL but frequency-domain optical-coherence-tomography (OCT) is a novel, promising, high resolution coronary imaging technique, which allows physiopathologic assessment of coronary plaque. We investigated the possible relation between OCT and FFR in selected ICL patients. Methods Stable or unstable patients with ICL who underwent both FFR and OCT assessment at two large tertiary centers were retrospectively enrolled. FFR was performed according to standard methodology. OCT images were (on blind to clinical and FFR results) analyzed to assess minimal lumen area (MLA), percentage area stenosis (AS), thrombus and plaque ulceration. Results Forty patients were identified (62 ± 10 years, 93% symptomatic, 35% acute presentation, 93% left-anterior-descending artery ICL). Percentage diameter stenosis at quantitative coronary angiography was 40 ± 12% and FFR was 0.85 ± 0.07. MLA (p = 0.009), AS (p < 0.001) and plaque ulceration (p = 0.02) were significantly associated with FFR values. An integrated assessment of AS (≥ or < 70%), MLA (≥ or < 2.5 mm2) and presence or absence of thrombus and plaque ulceration was found to have the potential to accurately (sensitivity 91%, specificity 93%) predict FFR results. Conclusion In patients with ICL, a combination of different OCT parameters may help predict FFR results. These findings suggest that only a comprehensive assessment of lesion features by OCT can allow an accurate prediction of lesion severity assessed by FFR.

AB - Background The decision-making process of patients with angiographically-intermediate coronary lesions (ICL) is clinically challenging and may benefit from adjunctive invasive techniques. Fractional-flow-reserve (FFR) represents the gold standard to evaluate ICL but frequency-domain optical-coherence-tomography (OCT) is a novel, promising, high resolution coronary imaging technique, which allows physiopathologic assessment of coronary plaque. We investigated the possible relation between OCT and FFR in selected ICL patients. Methods Stable or unstable patients with ICL who underwent both FFR and OCT assessment at two large tertiary centers were retrospectively enrolled. FFR was performed according to standard methodology. OCT images were (on blind to clinical and FFR results) analyzed to assess minimal lumen area (MLA), percentage area stenosis (AS), thrombus and plaque ulceration. Results Forty patients were identified (62 ± 10 years, 93% symptomatic, 35% acute presentation, 93% left-anterior-descending artery ICL). Percentage diameter stenosis at quantitative coronary angiography was 40 ± 12% and FFR was 0.85 ± 0.07. MLA (p = 0.009), AS (p < 0.001) and plaque ulceration (p = 0.02) were significantly associated with FFR values. An integrated assessment of AS (≥ or < 70%), MLA (≥ or < 2.5 mm2) and presence or absence of thrombus and plaque ulceration was found to have the potential to accurately (sensitivity 91%, specificity 93%) predict FFR results. Conclusion In patients with ICL, a combination of different OCT parameters may help predict FFR results. These findings suggest that only a comprehensive assessment of lesion features by OCT can allow an accurate prediction of lesion severity assessed by FFR.

KW - Optical coherence tomography

KW - Fractional flow reserve

KW - Intermediate coronary lesions

U2 - 10.1016/j.ijcard.2017.10.011

DO - 10.1016/j.ijcard.2017.10.011

M3 - Article

SN - 0167-5273

VL - 253

SP - 55

EP - 60

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -

Correlation between frequency-domain optical coherence tomography and fractional flow reserve in angiographically-intermediate coronary lesions

Abstract

Keywords

UN SDGs

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