Cardiovascular Diagnosis Parameters

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Questions and Answers

What was the best cutoff value for fractional flow reserve?

IVUS-ALM of 2.3 mm2

OCT-area of stenosis of 65.0%

IVUS-ALM of 3.8 mm2 (correct)

OCT-ALM of 2.3 mm2

What was the percentage of plaque burden for OCT-ALM?

60.0%

70.0%

65.0% (correct)

75.0%

What was the diagnostic accuracy of anatomical parameters?

Low, below 50%

Moderate, around 70-80% (correct)

High, above 90%

Moderate, around 50-60%

What was the correlation between physiological indices and anatomical parameters?

Moderate correlation Signup and view all the answers

Which test was used to measure fractional flow reserve?

IVUS and OCT Signup and view all the answers

What was the discriminative power of physiological indices?

Below 0.75 Signup and view all the answers

What was the clinical trial identifier for this study?

NCT03795714 Signup and view all the answers

Who published this study?

Elsevier España, S.L.U. Signup and view all the answers

What is a limitation of coronariography?

Showing the presence of myocardial ischemia Signup and view all the answers

What is an invasive physiological index used to guide clinical decisions?

Fractional flow reserve (FFR) Signup and view all the answers

What is used to evaluate coronary arteries in addition to coronariography?

Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) Signup and view all the answers

What is the significance of the discrepancy between angiographic stenosis intensity and myocardial ischemia?

It highlights the limitations of coronariography in diagnosing coronary artery disease Signup and view all the answers

What is the purpose of using invasive physiological indices?

To guide clinical decisions regarding revascularization Signup and view all the answers

Where was the study conducted?

At two university hospitals Signup and view all the answers

What is the time period during which the study was conducted?

Between 2009 and 2018 Signup and view all the answers

How many coronary arteries were evaluated using IVUS or OCT?

At least one Signup and view all the answers

What is the purpose of intracoronary imaging diagnostic techniques?

To evaluate the anatomical characteristics of the plaque Signup and view all the answers

What was excluded from the study?

Patients with unstable hemodynamics Signup and view all the answers

What was the goal of previous studies?

To explore the diagnostic value of quantitative parameters Signup and view all the answers

What was the limitation of previous studies?

The studies were limited by a moderate diagnostic accuracy Signup and view all the answers

What was the criterion for performing intravascular imaging exploration?

Operator's decision Signup and view all the answers

What was the purpose of the specific protocol for this analysis?

To approve the study by the ethics committee Signup and view all the answers

What was the relationship between the population of patients and the quantitative parameters?

The parameters were different depending on the population Signup and view all the answers

What was the factor that influenced the diagnostic value of the quantitative parameters?

The location of the lesions Signup and view all the answers

What was calculated from each wave with an offline algorithm?

RFR Signup and view all the answers

What was standardized before RFR calculation?

Frequency of sampling pressure Signup and view all the answers

What was applied to eliminate subcycle artifacts?

Low-pass filter Signup and view all the answers

What was defined as the point with the lowest Pa/Pd ratio?

RFR Signup and view all the answers

How many cardiac cycles were required for RFR determination?

5 Signup and view all the answers

What was calculated as the average of the Pd/Pa ratio?

dPR Signup and view all the answers

What was used to measure coronary physiological parameters?

Diagnostic coronary angiography Signup and view all the answers

Where was the algorithm used for RFR calculation developed?

Abbott Vascular, California, USA Signup and view all the answers

What is the role of intravascular ultrasound in coronary stenosis?

To evaluate the physiological significance of stenosis Signup and view all the answers

What is the purpose of fractional flow reserve?

To evaluate the physiological significance of stenosis Signup and view all the answers

What is the correlation between physiological indices and anatomical parameters?

Strong positive correlation Signup and view all the answers

What is the purpose of intravascular ultrasound-derived minimal lumen area?

To determine the functional significance of stenosis Signup and view all the answers

What is the role of quantitative computed tomography in coronary stenosis?

To provide anatomical parameters Signup and view all the answers

What is the purpose of head-to-head comparison of quantitative coronary angiography and quantitative computed tomography?

To compare the diagnostic accuracy of both methods Signup and view all the answers

What is the significance of minimal lumen area in left main coronary artery stenosis?

It is a criterion for functionally significant stenosis Signup and view all the answers

What is the purpose of the study mentioned in the text?

To define the optimal intravascular ultrasound criteria for intermediate coronary stenosis Signup and view all the answers

Study Notes

Coronary Artery Disease Diagnosis

Fractional flow reserve (FFR) is used to guide clinical decisions regarding revascularization.
Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are intracoronary imaging techniques that provide accurate anatomical information.
Physiological indices like FFR and instantaneous wave-free ratio (iFR) are used to predict functional significance of coronary stenosis.

Study Design and Population

The study included consecutive patients who underwent invasive coronary angiography for clinical indication.
IVUS or OCT examination of at least one coronary artery was performed.
Patients with hemodynamic instability, left ventricular dysfunction, or acute coronary syndrome were excluded.

Parameters and Measurements

FFR was calculated using an offline algorithm (Abbott Vascular, Santa Clara, CA, USA) with a standardized sampling frequency of 100 Hz.
The pressure wire was used to measure the pressure curves.
The minimal lumen diameter, reference vessel diameter, and lesion length were measured.
The SYNTAX score was determined according to previously published methods.

Key Findings

The best cut-off values for fractional flow reserve were IVUS-ALM of 3.8 mm², plaque burden of 70.0%, OCT-ALM of 2.3 mm², and OCT stenosis area of 65.0%.
Physiological indices at rest showed an identical correlation with quantitative plaque characteristics defined by IVUS or OCT.
Fractional flow reserve showed a stronger correlation with IVUS or OCT parameters than physiological indices at rest.

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Description

This quiz assesses your understanding of the best cut-off values for fractional flow reserve, including IVUS-ALM, OCT-ALM, and OCT-area of stenosis. It covers the predictive accuracy of diagnostic parameters derived from IVUS and OCT.