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01-11-2007 | Original article

Long-term prognostic value of CFVR and FFR versus perfusion scintigraphy in patients with multivessel disease

Auteurs: S. A. J. Chamuleau, B. L. F. van Eck-Smit, M. Meuwissen, K. T. Koch, M. G. W. Dijkgraaf, H. J. Verberne, J. G. P. Tijssen, J. J. Piek

Gepubliceerd in: Netherlands Heart Journal | Uitgave 11/2007

Abstract

ObjectiveIn this multicentre study, we investigated the long-term prognostic value of intracoronary derived haemodynamic parameters compared with the results of myocardial perfusion scintigraphy (MPS).

MethodsPatients (n=191) who were referred for angioplasty of a severe lesion in the presence of an intermediate lesion in another coronary artery were included. MPS was performed to determine the presence of reversible perfusion defects in the area of the intermediate lesion. Coronary flow velocity reserve (CFVR), and additionally fractional flow reserve (FFR; n=129), were determined distal to the intermediate lesion; CFVR ≥2.0 and FFR ≥0.75 were considered negative.

ResultsIn total 67 events occurred in 49 patients (3 deaths, 9 MI, 9 CABG, 46 PTCA) during a mean of 793 days follow-up. Event-free survival was 63% for MPS, 79% for CFVR, and 79% for FFR if a negative test result was obtained. The relative risk was 1.2 (not significant) for MPS, 2.2 (p=0.001) for CFVR, and 2.4 (p=0.004) for FFR.

ConclusionSelective evaluation of an intermediate lesion using CFVR or FFR allows more adequate risk stratification in patients with multivessel disease than MPS. A CFVR <2.0 or a FFR <0.75 was associated with a significant increase of the occurrence of cardiac events during long-term follow-up, predominantly associated with revascularisation. (Neth Heart J 2007;15:369-74.)

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Titel: Long-term prognostic value of CFVR and FFR versus perfusion scintigraphy in patients with multivessel disease
Auteurs: S. A. J. Chamuleau
B. L. F. van Eck-Smit
M. Meuwissen
K. T. Koch
M. G. W. Dijkgraaf
H. J. Verberne
J. G. P. Tijssen
J. J. Piek
Publicatiedatum: 01-11-2007
Uitgeverij: Bohn Stafleu van Loghum
Gepubliceerd in: Netherlands Heart Journal / Uitgave 11/2007
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI: https://doi.org/10.1007/BF03086017

Bohn Stafleu van Loghum

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