중등도 관상동맥 협착 질환에서 혈관내초음파로 측정된 변수와 심근 분획 혈류 예비력과의 상관 관계
Relationship Between Intravascular Ultrasound Parameters and Fractional Flow Reserve in Intermediate Coronary Artery Stenosis of Left Anterior Descending Artery
- 주제(키워드) Intravascular ultrasound , Fractional flow reserve , Plaque volume
- 발행기관 아주대학교
- 지도교수 탁승제
- 발행년도 2013
- 학위수여년월 2013. 8
- 학위명 박사
- 학과 및 전공 일반대학원 의학계열
- 실제URI http://www.dcollection.net/handler/ajou/000000014744
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Background/Objectives: The objective of this study was to assess the relationship between intravascular ultrasound (IVUS) parameters, including volumetric analysis, and fractional flow reserve (FFR). Methods: Both IVUS and FFR were performed in 206 cases of intermediate stenosis of the left anterior descending artery (LAD). Myocardial ischemia was assessed by FFR and maximal hyperemia was induced by continuous intracoronary adenosine infusion. FFR < 0.80 was considered as significant inducible myocardial ischemia. We performed standard IVUS parameter measurements and volumetric analyses. IVUS parameter comparison was performed in the presence (n=90) or absence (n=116) of significant myocardial ischemia. Results: Lesions with minimal lumen area (MLA) ≥4.0mm2 had FFR ≥0.80 in 91.4% of cases, while 50.9% of lesions with MLA <4.0mm2 had FFR <0.80. The multiple logistic regression analysis demonstrated that IVUS lesion length (odds ratio [OR]: 1.1, 95% confidence interval [CI] =1.1–1.2, p<0.001) and MLA significance according to lesion location (OR: 8.8, 95% CI = 4.4-17.8, p< 0.001) were independent predictors of functionally significant myocardial ischemia (FFR < 0.80). FFR correlated with plaque volume (r= -0.345, p<0.001) and percent atheroma volume (PAV) (r=-0.398, p<0.001). Lesions with significant ischemia (FFR <0.80) as compared to those with FFR >0.80 were associated with larger plaque volume (181.8±82.3 vs. 125.9±77.9 mm3, p<0.001) and PAV (58.9±5.6 vs. 53.8± 7.9 %, p<0.001). Conclusions: IVUS parameters representing severity and extent of atheromatous plaque correlated with functional significance in LAD lesions with intermediate stenosis.
more목차
ABSTRACT ⅰ
TABLE OF CONTENTS ⅱi
LIST OF FIGURES iv
LIST OF TABLES v
I. INTRODUCTION 1
II. MATERIALS AND METHODS 3
A. Study population 3
B. Quantitative coronary angiography 3
C. Intravascular ultrasound analyses 4
D. Measurement of fractional flow reserve 5
E. Statistical analysis 5
III. RESULTS
A. Baseline clinical and angiographic characteristics 7
B. Relationship between FFR and IVUS parameters 10
C. IVUS parameters for functionally significant myocardial ischemia 14
D. IVUS volumetric analysis and FFR 17
IV. DISUCUSSION 20
V. CONCLUSION 24
REFERENCES 25
국문요약 30
