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Published on: June 28, 2019

Fractional flow reserve in a patient with intermediate coronary stenosis and hypertrophic cardiomyopathy

Masaki Tsukamoto1, Akihiro Azuma, Toshiro Kuribayashi

  • 1Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan. mtsuka@koto.kpu-m.ac.jp

Journal of Interventional Cardiology
|June 11, 2002
PubMed

Insights

Fractional flow reserve (FFRmyo) effectively assessed significant coronary artery stenosis in a hypertrophic cardiomyopathy patient. This pressure-derived index guided successful intervention, improving symptoms and ischemia.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Diagnostic Imaging

Background:

  • Hypertrophic cardiomyopathy (HCM) can present with exertional chest pain, often due to coronary artery disease.
  • Assessing the functional significance of intermediate coronary stenoses is crucial for guiding treatment decisions.

Observation:

  • A 61-year-old male with HCM experienced exertional chest pain.
  • Coronary angiography showed intermediate left anterior descending artery stenosis.
  • Tc-99m myocardial scintigraphy indicated exercise-induced ischemia.

Findings:

  • Both coronary flow reserve (CFR) and fractional flow reserve (FFRmyo) were reduced, indicating functional significance.
  • Directional coronary atherectomy improved FFRmyo to 0.99, relieved angina, and resolved scintigraphic ischemia.
  • CFR did not improve post-intervention.

Implications:

  • FFRmyo is valuable for evaluating equivocal coronary stenoses in HCM patients.
  • Interventional treatment guided by FFRmyo can effectively resolve significant stenoses and improve clinical outcomes.
  • Discrepancies between CFR and FFRmyo warrant further investigation.

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