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Yong ASC, Javadzadegan A, Fearon WF, et al. The relationship between coronary artery distensibility and fractional flow reserve. PLoS One. 2017;12(7):e0181824doi: 10.1371/journal.pone.0181824.
Yong, A. S. C., Javadzadegan, A., Fearon, W. F., Moshfegh, A., Lau, J. K., Nicholls, S., Ng, M. K. C., & Kritharides, L. (2017). The relationship between coronary artery distensibility and fractional flow reserve. PloS one, 12(7), e0181824. https://doi.org/10.1371/journal.pone.0181824
Yong, Andy S C, et al. "The relationship between coronary artery distensibility and fractional flow reserve." PloS one vol. 12,7 (2017): e0181824. doi: https://doi.org/10.1371/journal.pone.0181824
Yong ASC, Javadzadegan A, Fearon WF, Moshfegh A, Lau JK, Nicholls S, Ng MKC, Kritharides L. The relationship between coronary artery distensibility and fractional flow reserve. PLoS One. 2017 Jul 25;12(7):e0181824. doi: 10.1371/journal.pone.0181824. eCollection 2017. PMID: 28742827; PMCID: PMC5526528.
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PLoS One. 2017 Jul 25;12(7):e0181824. doi: 10.1371/journal.pone.0181824. eCollection 2017.

The relationship between coronary artery distensibility and fractional flow reserve.

PloS one

Andy S C Yong, Ashkan Javadzadegan, William F Fearon, Abouzar Moshfegh, Jerrett K Lau, Stephen Nicholls, Martin K C Ng, Leonard Kritharides

Affiliations

  1. Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
  2. ANZAC Research Institute, The University of Sydney, Sydney, New South Wales, Australia.
  3. Department of Cardiology, Concord Hospital, The University of Sydney, Sydney, New South Wales, Australia.
  4. Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford, California, United States of America.
  5. South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
  6. Royal Prince Alfred Hospital, The University of Sydney, Sydney, New South Wales, Australia.

PMID: 28742827 PMCID: PMC5526528 DOI: 10.1371/journal.pone.0181824

Abstract

Discordance between angiography-based anatomical assessment of coronary stenosis severity and fractional flow reserve (FFR) has been attributed to several factors including lesion length and irregularity, and the myocardial territory supplied by the target vessel. We sought to examine if coronary arterial distensibility is an independent contributor to this discordance. There were two parts to this study. The first consisted of "in silico" models of 26 human coronary arteries. Computational fluid dynamics-derived FFR was calculated for fully rigid, partially distensible and fully distensible models of the 26 arteries. The second part of the study consisted of 104 patients who underwent coronary angiography and FFR measurement. Distensibility at the lesion site (DistensibilityMLA) and for the reference vessel (DistensibilityRef) was determined by analysing three-dimensional angiography images during end-systole and end-diastole. Computational fluid dynamics-derived FFR was 0.67±0.19, 0.70±0.18 and 0.75±0.17 (P<0.001) in the fully rigid, partially distensible and fully distensible models respectively. FFR correlated with both DistensibilityMLA (r = 0.36, P<0.001) and DistensibilityRef (r = 0.44, P<0.001). Two-way ANCOVA analysis revealed that DistensibilityMLA (F (1, 100) = 4.17, p = 0.031) and percentage diameter stenosis (F (1, 100) = 60.30, p < 0.01) were both independent predictors of FFR. Coronary arterial distensibility is a novel, independent determinant of FFR, and an important factor contributing to the discordance between anatomical and functional assessment of stenosis severity.

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