Usefulness of Minimal Luminal Coronary Area Determined by Intravascular Ultrasound to Predict Functional Significance in Stable and Unstable Angina Pectoris

Little is known about the intravascular ultrasound (IVUS) minimal lumen area (MLA) criteria and their accuracy in lesion subsets assorted according to vessel type, lesion location, vessel size, and clinical settings. We therefore assessed the accuracy of subgroup-specific cut-off values in predictin...

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Published in:The American journal of cardiology 2012-04, Vol.109 (7), p.947-953
Main Authors: Kang, Soo-Jin, MD, PhD, Ahn, Jung-Min, MD, Song, Haegeun, MD, Kim, Won-Jang, MD, Lee, Jong-Young, MD, Park, Duk-Woo, MD, PhD, Yun, Sung-Cheol, PhD, Lee, Seung-Whan, MD, PhD, Kim, Young-Hak, MD, PhD, Lee, Cheol Whan, MD, PhD, Park, Seong-Wook, MD, PhD, Park, Seung-Jung, MD, PhD
Format: Article
Language:English
Subjects:
Accuracy
Adult
Aged
Aged, 80 and over
Algorithms
Angina, Stable - diagnostic imaging
Angina, Stable - pathology
Angina, Unstable - diagnostic imaging
Angina, Unstable - pathology
Biological and medical sciences
Cardiology. Vascular system
Cardiovascular
Cardiovascular disease
Coronary heart disease
Coronary Vessels - diagnostic imaging
Coronary Vessels - pathology
Female
Heart
Humans
Ischemia
Male
Medical diagnosis
Medical sciences
Middle Aged
Predictive Value of Tests
Retrospective Studies
Risk Factors
Sensitivity and Specificity
Ultrasonic imaging
Ultrasonography, Interventional
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creator Kang, Soo-Jin, MD, PhD
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Yun, Sung-Cheol, PhD
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Kim, Young-Hak, MD, PhD
Lee, Cheol Whan, MD, PhD
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Park, Seung-Jung, MD, PhD
description Little is known about the intravascular ultrasound (IVUS) minimal lumen area (MLA) criteria and their accuracy in lesion subsets assorted according to vessel type, lesion location, vessel size, and clinical settings. We therefore assessed the accuracy of subgroup-specific cut-off values in predicting fractional flow reserve (FFR)
doi_str_mv 10.1016/j.amjcard.2011.11.024
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We therefore assessed the accuracy of subgroup-specific cut-off values in predicting fractional flow reserve (FFR) &lt;0.80. In total 692 consecutive patients with 784 coronary lesions were assessed by IVUS and FFR before intervention. All patients had ≥1 target vessel with a de novo lesion (30% to 90% diameter stenosis). For prediction of FFR &lt;0.80 in the group overall, the best cut-off value of MLA was 2.4 mm2 (sensitivity 84% and specificity 63%). Overall diagnostic accuracy was only 69%. In the subgroup analysis, the MLA cutoff was 2.4 mm2 for the left anterior descending coronary artery, 1.6 mm2 for the left circumflex coronary artery, and 2.4 mm2 for the right coronary artery. By lesion location, the optimal cutoff was 2.6 mm2 for proximal, 2.3 mm2 for mid, and 1.9 mm2 for distal segments. Furthermore, the cutoffs were 3.2 mm2 in lesions with a larger RLD &gt;3.5 mm and 1.9 mm2 in lesions with a smaller RLD &lt;2.75 mm. 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subjects Accuracy
Adult
Aged
Aged, 80 and over
Algorithms
Angina, Stable - diagnostic imaging
Angina, Stable - pathology
Angina, Unstable - diagnostic imaging
Angina, Unstable - pathology
Biological and medical sciences
Cardiology. Vascular system
Cardiovascular
Cardiovascular disease
Coronary heart disease
Coronary Vessels - diagnostic imaging
Coronary Vessels - pathology
Female
Heart
Humans
Ischemia
Male
Medical diagnosis
Medical sciences
Middle Aged
Predictive Value of Tests
Retrospective Studies
Risk Factors
Sensitivity and Specificity
Ultrasonic imaging
Ultrasonography, Interventional
title Usefulness of Minimal Luminal Coronary Area Determined by Intravascular Ultrasound to Predict Functional Significance in Stable and Unstable Angina Pectoris
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