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Clinical Research in Cardiology

, Volume 104, Issue 1, pp 59–70 | Cite as

Correlation between optical coherence tomography-derived intraluminal parameters and fractional flow reserve measurements in intermediate grade coronary lesions: a comparison between diabetic and non-diabetic patients

  • Sebastian Reith
  • Simone Battermann
  • Martin Hellmich
  • Nikolaus Marx
  • Mathias Burgmaier
Original Paper

Abstract

Background

Fractional flow reserve (FFR) measurements accurately assess functional relevance in intermediate grade coronary lesions. A significant relationship between hemodynamic stenosis severity and optical coherence tomography (OCT)-derived intraluminal dimensions has recently been demonstrated. However, morphologic thresholds to identify significant stenoses are variable and exploration of this correlation in patients with diabetes mellitus (DM) remains currently incomplete. This study aimed at comparing the diagnostic value of intraluminal parameters as determined by OCT to predict FFR ≤0.8 in lesions of patients with versus without DM.

Methods

In 100 patients (DM = 56, non-DM = 44) with 142 coronary de novo lesions (DM = 80, non-DM = 62) of intermediate grade as determined by quantitative coronary angiography, we performed OCT and FFR. Stenoses were defined functionally relevant if FFR was ≤0.8.

Results

FFR measurements in the overall study cohort, the DM and the non-DM group correlated significantly with minimal lumen area (MLA) [overall: r 2 = 0.339, DM: r 2 = 0.341, non-DM: r 2 = 0.355 (all p < 0.001)], percent area stenosis [overall: r 2 = 0.352, DM: r 2 = 0.376, non-DM: r 2 = 0.351 (all p < 0.001)] and minimal lumen diameter [overall: r 2 = 0.333, DM: r 2 = 0.277, non-DM: r 2 = 0.417 (all p < 0.001)] without differing statistically between diabetic and non-diabetic patients (p = ns).

Receiver operating characteristic analysis demonstrated that among OCT-derived parameters, MLA predicted FFR ≤0.8 with the best diagnostic efficiency and with similar cut-off values for all patients [area under the curve (AUC) = 0.836, 95 % confidence interval (CI) = 0.772–0.901, cut-off value = 1.64 mm2] as well as for diabetic (AUC = 0.840, 95 % CI = 0.754–0.927, cut-off value = 1.59 mm2) and non-diabetic subjects (AUC = 0.833, 95 % CI = 0.734–0.932, cut-off value = 1.64 mm2).

Conclusion

In both, diabetic and non-diabetic patients, FFR and OCT-derived intraluminal measurements are significantly correlated and OCT predicts hemodynamically relevant coronary stenosis with moderate diagnostic efficiency.

Keywords

Quantitative coronary angiography Minimal lumen area Optical coherence tomography Fractional flow reserve Type 2 diabetes mellitus 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Sebastian Reith
    • 1
  • Simone Battermann
    • 1
  • Martin Hellmich
    • 2
  • Nikolaus Marx
    • 1
  • Mathias Burgmaier
    • 1
  1. 1.Department of Cardiology, Medical Clinic IUniversity Hospital of the RWTH AachenAachenGermany
  2. 2.Institute of Medical Statistics, Informatics and Epidemiology, University of CologneCologneGermany

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