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Updated: Dec 25, 2025
Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice
Published on: April 13, 2015
Extent of the difference between microcatheter and pressure wire-derived fractional flow reserve and its relation to
Yoshiki Matsuo1, Yasutsugu Shiono1, Kuninobu Kashiyama2
1The Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
Background:
Although previous studies demonstrated that microcatheter-derived fractional flow reserve (mc-FFR) tends to overestimate lesion severity compared to pressure wire-derived FFR (pw-FFR), the clinical utility of mc-FFR remains obscure. The extent of differences between the two FFR systems and its relation to a lesion-specific parameter remain unknown. In this study, we sought to compare mc-FFR with pw-FFR and determine the lower and upper mc-FFR cut-offs predicting ischemic and non-ischemic stenosis, using an ischemic and a clinical FFR threshold of 0.75 and 0.80 as references, respectively. We further explored optical coherence tomography (OCT) parameters influencing the difference in FFR between the two systems.
Methods And Results:
In this study, 44 target vessels with intermediate de novo coronary artery lesion in 36 patients with stable ischemic heart disease were evaluated with mc-FFR, pw-FFR and OCT. Bland-Altman plots for mc-FFR versus pw-FFR showed a bias of -0.04 for lower mc-FFR values compared to pw-FFR values. The mc-FFR cut-off values of 0.73 and 0.79 corresponded to the 0.75 ischemic pw-FFR and 0.80 clinical pw-FFR thresholds with high predictive values, respectively. The differences in the two FFR measurements (pw-FFR minus mc-FFR) were negatively correlated with OCT-derived minimum lumen area (MLA) (R = -0.359, p = 0.011). The OCT-derived MLA of 1.36 mm2 was a cut-off value for predicting the clinically significant difference between the two FFR measurements defined as >0.03.
Conclusion:
Mc-FFR is clinically useful when the specific cut-offs are applied. An OCT-derived MLA accounts for the clinically significant difference in FFR between the two systems.
Insights
Microcatheter-derived fractional flow reserve (mc-FFR) is clinically useful for assessing coronary artery stenosis when specific cut-offs are applied. Optical coherence tomography-derived minimum lumen area helps explain significant differences between mc-FFR and pressure wire-derived FFR (pw-FFR).
Area of Science:
- Cardiovascular Interventions
- Intracoronary Physiology
- Coronary Artery Disease
Background:
- Microcatheter-derived fractional flow reserve (mc-FFR) may overestimate stenosis severity compared to pressure wire-derived FFR (pw-FFR).
- The clinical utility and discrepancies between mc-FFR and pw-FFR are not fully understood.
- Optical coherence tomography (OCT) parameters influencing these differences require investigation.
Purpose of the Study:
- To compare mc-FFR with pw-FFR in intermediate coronary artery lesions.
- To establish mc-FFR cut-off values for predicting ischemic and non-ischemic stenosis.
- To explore OCT parameters associated with differences between mc-FFR and pw-FFR.
Main Methods:
- 44 vessels with intermediate de novo coronary artery lesions were evaluated using mc-FFR, pw-FFR, and OCT.
- Bland-Altman analysis assessed agreement between mc-FFR and pw-FFR.
- Correlation analysis explored the relationship between OCT parameters and FFR differences.
Main Results:
- mc-FFR showed a bias of -0.04 compared to pw-FFR.
- mc-FFR cut-offs of 0.73 and 0.79 predicted ischemic (0.75) and clinical (0.80) pw-FFR thresholds.
- OCT-derived minimum lumen area (MLA) negatively correlated with FFR differences (R=-0.359, p=0.011); an MLA of 1.36 mm² predicted significant FFR discrepancies (>0.03).
Conclusions:
- mc-FFR demonstrates clinical utility when appropriate cut-offs are utilized.
- OCT-derived MLA is a significant factor explaining the discrepancies between mc-FFR and pw-FFR.
- These findings aid in the accurate interpretation of mc-FFR measurements in clinical practice.
