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Comparison of fractional flow reserve and angiographic characteristics after balloon angioplasty in de novo coronary lesions

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Abstract

Lesion characteristics determined by angiography after balloon angioplasty such as residual dimeter stenosis (DS) or dissection type has been used to determine the treatment method of drug-coated balloon (DCB) or metal stent for de novo coronary lesions. The aim of this study is to identify angiographic and functional mismatch using residual DS, dissection type and fractional flow reserve (FFR). Baseline and post-balloon parameters were obtained from 151 patients with 167 lesions. Angiographically significant parameters after balloon angioplasty are residual DS > 30% or dissection type C or more. Post-balloon FFR cutoff value of 0.75 was used to define functionally significant lesions. The weak correlation was found between residual DS and post-balloon FFR (r =  − 0.317, p < 0.001). There were 68.7% of mismatch population (residual DS > 30% and post-balloon FFR ≥ 0.75) and 7.1% of reverse mismatch population (residual DS ≤ 30% and post-balloon FFR < 0.75). All reverse mismatch lesions were found in left anterior descending artery. There was no correlation between dissection severity and post-balloon FFR (p = 0.654). In high post-balloon FFR group, long-term clinical outcomes showed no difference between DCB and stent groups with (p = 0.788) or without (p = 0.426) the adjustment of lesion characteristics. There were high frequencies of mismatch between angiographic lesion characteristics and FFR values after balloon angioplasty. Post-balloon FFR measurements may be safe and effective compared to angiography-guided treatment if DCB only treatment is considered.

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Abbreviations

BA:

Balloon angioplasty

DCB:

Drug-coated balloon

DS:

Diameter stenosis

FFR:

Fractional flow reserve

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Authors and Affiliations

  1. Division of Cardiology, Ulsan Medical Center, Ulsan Hospital, 13, Wolpyeong-ro 171beon-gil, Nam-gu, Ulsan, 44686, Republic of Korea

    Ju-Hyun Chung & Eun-Seok Shin

  2. Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon, Republic of Korea

    Kyung Eun Lee

  3. Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea

    Ae-Young Her

  4. Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Joo Myung Lee

  5. Department of Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea

    Joon-Hyung Doh

  6. Department of Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea

    Chang-Wook Nam

  7. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea

    Bon-Kwon Koo

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  1. Ju-Hyun Chung
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Correspondence to Eun-Seok Shin.

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Chung, JH., Lee, K.E., Her, AY. et al. Comparison of fractional flow reserve and angiographic characteristics after balloon angioplasty in de novo coronary lesions. Int J Cardiovasc Imaging 35, 1945–1954 (2019). https://doi.org/10.1007/s10554-019-01649-y

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  • DOI: https://doi.org/10.1007/s10554-019-01649-y

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