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FFR=1.0 flow changes after percutaneous coronary intervention.

Junji Matsuda1, Rikuta Hamaya2, Masahiro Hoshino3

  • 1Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.

Journal of Cardiology
|January 2, 2021
PubMed
Summary
This summary is machine-generated.

Anticipated maximum flow (AMF) can predict increased coronary flow after percutaneous coronary intervention (PCI), even when fractional flow reserve (FFR) improves. Pre-PCI AMF offers valuable insights into post-PCI flow changes.

Keywords:
Average peak coronary flow velocityCoronary flow increaseCoronary flow reserveFractional flow reservePercutaneous coronary intervention

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Physiology

Background:

  • Percutaneous coronary intervention (PCI) aims to improve coronary flow, but studies show flow doesn't always increase despite fractional flow reserve (FFR) improvement.
  • A novel index, anticipated maximum flow (AMF), theoretically represents coronary flow when FFR equals 1.

Purpose of the Study:

  • To investigate the relationship between physiological indices and increased coronary flow during PCI.
  • To evaluate the utility of AMF in predicting coronary flow changes after PCI.

Main Methods:

  • Retrospective analysis of 71 lesions treated with elective PCI.
  • Calculated AMF using hyperemic average peak coronary flow velocity (h-APV) and FFR.
  • Assessed the relationship between pre-PCI and post-PCI AMF and coronary flow changes.

Main Results:

  • Post-PCI AMF differed significantly from pre-PCI AMF, explaining discordance between FFR improvement and coronary flow changes.
  • Increased coronary flow (>50%) was linked to lower pre-PCI FFR, lower pre-PCI AMF, and other hemodynamic factors.
  • Pre-PCI AMF significantly predicted >50% coronary flow increase when added to a clinical model with pre-PCI FFR.

Conclusions:

  • Pre-PCI AMF has incremental predictive value for post-PCI coronary flow increase.
  • AMF impacts the understanding of discordance between FFR improvement and actual coronary flow changes after PCI.