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Vol 19 (2024): Continuous Publishing
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Published online: 2023-12-20

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Usefulness of assessment of fractional flow reserve and coronary flow velocity reserve in determination of the significance of borderline stenoses in the anterior descending artery in patients with multivessel disease

Łukasz Jankowski1, Jan Zbigniew Peruga1, Karina Wierzbowska-Drabik2, Dawid Miśkowiec1, Marcin Ojrzanowski1, Błażej Michalski1, Jarosław Damian Kasprzak1, Michał Plewka3
DOI: 10.5603/fc.97001


Introduction. Assessment of the significance of borderline stenosis in the area of the anterior descending artery in patients with multivessel coronary artery disease is a challenge. Currently, ractional flow reserve (FFR) and coronary flow reverse (CFR) methods are available. Aim. The aim of the study was to compare the usefulness of fractional flow reverse (FFR) and CFR methods in the assessment of left anterior descending artery (LAD) borderline stenosis in patients with multivessel coronary disease (MVD) and isolated LAD stenosis.

Material and methods. We examined 100 patients with suspected ischemic heart disease. The examination revealed MVD disease with borderline stenosis of the LAD in 23 patients. Significant changes were confirmed with FFR and CFR.

Results. Abnormal FFR (82% vs. 22%; p < 0.001) and abnormal CFR (32% vs. 12%; p = 0.029) were significantly more commonly observed in patients with MVD. The mean FFR (0.76 vs. 0.84; p < 0.001), the mean CFR (2.13 vs. 2.31; p = 0.075). Positive CFR and FFR values were found in 7 MVD patients and in 3 patients with single-vessel lesions (32% vs. 4%; p < 0.001). Negative CFR and positive FFR values were noted in 11 patients with MVD and 14 with lesions only in LAD (50% vs. 18%; p < 0.001). Positive CFR and negative FFR 0 vs 6 patients (0% vs. 8%; p < 0.001). Negative CFR and negative FFR were obtained in 4 patients from the MVD group and in 55 patients from the group of borderline stenosis only in LAD (18% vs. 71%; p < 0.001). MACE was observed significantly more frequently in the MVD group than in the group of patients with borderline lesions only in LAD (47% vs. 6%; p = 0.004).

Conclusions. Positive FFR and CFR results correlate with more frequent MACE episodes.

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