Portal de Periódicos da CAPES

Diagnostic and Prognostic Efficacy of Coronary Flow Capacity Obtained Using Pressure-Temperature Sensor–Tipped Wire–Derived Physiological Indices

2018; Elsevier BV; Volume: 11; Issue: 8 Linguagem: Inglês

10.1016/j.jcin.2018.01.249

1936-8798

Rikuta Hamaya, Taishi Yonetsu, Yoshihisa Kanaji, Eisuke Usui, Masahiro Hoshino, Masao Yamaguchi, Masahiro Hada, Yoshinori Kanno, Tadashi Murai, Kenzo Hirao, Tsunekazu Kakuta,

Advanced MRI Techniques and Applications

This study aimed to evaluate the feasibility and efficacy of pressure-temperature sensor–tipped wire–derived coronary flow capacity (PTW-CFC) for assessing flow impairment and prognosis. CFC provides an integrated coronary physiological assessment in which coronary flow reserve and coronary flow during hyperemia are organized. A total of 643 native de novo lesions for which physiological assessments were performed using a PressureWire (St. Jude Medical, St. Paul, Minnesota) in patients with stable coronary artery disease were identified. The entire cohort was stratified by PTW-CFC according to the well-validated thresholds of coronary flow reserve and the corresponding inverse of thermodilution-derived mean transit time under hyperemia. Coronary physiological indices and the prevalence of major adverse cardiac events (MACE) were assessed according to PTW-CFC categories. Furthermore, in patients who underwent percutaneous coronary intervention (PCI), post-PCI PTW-CFC categorization was performed and clinical outcomes were evaluated. PTW-CFC categorization efficiently discriminated previously validated coronary physiological parameters for functional stenosis severity and microvascular dysfunction. MACE rates during follow-up (2.4 years) were significantly associated with advanced impairment of PTW-CFC except for severely reduced PTW-CFC. In the subgroup analysis of patients with severely reduced pre-PCI PTW-CFC who underwent successful PCI, MACE incidence was significantly frequent in patients with post-PCI non-normal PTW-CFC compared with those with post-PCI normal PTW-CFC. PTW-CFC mapping was feasible, provided accurate stratifications of coronary flow impairment, and may predict MACE. Combined analysis involving PTW-CFC and fractional flow reserve may enrich the clinical implication of integrated coronary physiology and may help predict prognosis.