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Updated: Jun 24, 2026
Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
Published on: June 28, 2019
The impact of multiple vessel disease on fractional flow reserve
Asife Sahinarslan1, Sinan Altan Kocaman, Fatma Hizal
1Gazi University, School of Medicine, Cardiology Department, Ankara, Turkey. asifesah@yahoo.com
Insights
The extent of coronary artery disease can influence fractional flow reserve (FFR) measurements, potentially leading to misinterpretations of lesion severity. This study found that a higher Gensini score correlated with lower FFR values in patients with significant lesions.
Area of Science:
- Cardiology
- Interventional Cardiology
- Diagnostic Imaging
Background:
- Fractional flow reserve (FFR) is a key diagnostic tool for assessing intermediate coronary artery lesions.
- The influence of multivessel coronary artery disease on FFR measurements remains incompletely understood.
- This study investigates how lesions in other coronary arteries impact FFR values.
Purpose of the Study:
- To determine if the overall burden of coronary artery disease affects FFR measurements.
- To explore the relationship between coronary artery disease severity (Gensini score) and FFR values.
- To assess the potential for misinterpretation of lesion severity due to multivessel disease.
Main Methods:
- FFR was measured in 113 patients with intermediate lesions in the left anterior descending artery.
- Patients were grouped based on FFRmin values (<0.80 or ≥0.80).
- The correlation between Gensini score and FFR values was analyzed within these groups, and also by the number of diseased vessels.
Main Results:
- A significant negative correlation was observed between Gensini score and FFR values (FFRbase and FFRmin) in patients with FFR < 0.80.
- Increasing numbers of significantly diseased coronary arteries were associated with lower FFRbase and FFRmin values.
- No significant relationship was found between Gensini score, FFR values, and the number of diseased vessels in patients with FFR ≥ 0.80.
Conclusions:
- The overall extent and severity of coronary artery disease can impact FFR measurements.
- Multivessel coronary artery disease may lead to an underestimation of lesion severity.
- Careful consideration of the patient's coronary artery disease burden is necessary for accurate FFR interpretation.
Background:
Fractional flow reserve (FFR) is a method for the assessment of intermediate lesions. The impact of lesions at other coronary arteries on the FFR is not clear. We aimed to investigate the impact of the lesions in the other coronary arteries on FFR measurement.
Method:
FFR was performed in 113 patients with intermediate lesions at the left anterior descending artery. FFR values at baseline (FFRbase) and after adenosine administration (FFRmin) were detected. We divided the patients into groups according to FFRmin value. The first group consisted of 52 patients with a FFR < 0.80 and the second group consisted of 61 patients with a FFR > or = 0.80. We investigated the relationship between Gensini score and FFR values within the groups.
Results:
A significant negative correlation was found in the analysis comparing Gensini score with FFRbase and FFRmin among the first group (r = -0.248, P = 0.009 and r = -0.685, P < 0.001, respectively). The relative FFR ratio was also significantly related with the Gensini score in the first group (r = -210, P = 0.047).When we divided the patients into 3 subgroups according to the number of the coronary arteries with significant lesion (> or = 70% stenosis) (group I: 1 vessel, group II: 2 vessels, group III: 3 vessels), we observed a relation with FFRbase (0.89 +/- 0.05 vs. 0.87 +/- 0.06 vs. 0.81 +/- 0.09, respectively, P = 0.007) and FFRmin (0.76 +/- 0.04 vs. 0.75 +/- 0.05 vs. 0.68 +/- 0.1 respectively, P = 0.002). In the second group, there was no relationship between Gensini score, FFR values and number of significantly diseased vessels.
Conclusion:
The overall extent and severity of coronary artery disease in a patient may affect the FFR measurement and may lead to misinterpretation of the lesion severity.
