Influence of different physiological hemodynamics on fractional flow reserve values in the left coronary artery and right coronary artery
Background Although the left coronary artery (LCA) has a flow profile in that most blood flow occurs during diastole rather than systole, the right coronary artery (RCA) has a flow pattern that is less diastolic dominant. This study assessed whether coronary pressure waveforms distal to stenoses wit...
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| Veröffentlicht in: | Heart and vessels 2021-08, Vol.36 (8), p.1125-1131 |
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| creator | Wada, Kensaku Fujii, Kenichi Horitani, Keita Kishimoto, Hiroshi Hashimoto, Kenta Shibutani, Hiroki Tsujimoto, Satoshi Matsumura, Koichiro Otagaki, Munemitsu Morishita, Shun Iwasaki, Masayoshi Shiojima, Ichiro |
| description | Background
Although the left coronary artery (LCA) has a flow profile in that most blood flow occurs during diastole rather than systole, the right coronary artery (RCA) has a flow pattern that is less diastolic dominant. This study assessed whether coronary pressure waveforms distal to stenoses with the same fractional flow reserve (FFR) was the same between the LCA and RCA.
Methods
A total of 347 vessels from 318 patients who underwent FFR measurements were included. Conventional FFR was calculated as the ratio of the mean coronary distal pressure (Pd) to the mean aortic pressure (Pa) at maximal hyperemia. The pressure drop ratios in systole (PDR
systole
) and diastole (PDR
diastole
) were calculated as the sum of (Pa minus Pd) divided by the sum of Pa at the intracoronary diastolic and systolic pressure phases, respectively.
Results
Analysis of covariance of the regression line of correlation between conventional FFR and PDR
systole
revealed that the slope was significantly greater in the RCA than in the left anterior descending artery (LAD) and left circumflex artery (LCX) (−0.765, −0.578, and −0.589,
p
|
| doi_str_mv | 10.1007/s00380-021-01797-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2487435919</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2548930107</sourcerecordid><originalsourceid>FETCH-LOGICAL-c399t-89b68a0e8b121ecae91c6db51925b415ec5106230b9087756dcd698bc8bae68c3</originalsourceid><addsrcrecordid>eNp9kc1u1DAUhS0EokPbF2CBLLFhE3ptx7G9RBXQSpXYlLXlONczqRJ7sDNF0zfgrfF0CkggsbqL891zfw4hrxm8ZwDqogAIDQ1w1gBTRjUPz8iKdUw2XCrxnKzAMGi04OqEvCrlDoBJw8xLciKElNBytSI_rmOYdhg90hToMIaAGeNCt5t9GdOU1qN3E93gnIZ9dPPoC02Rhuz8MqZYpTCl7zRjwXyP9N5Vr0LHSJcN0gnDQn3Klct76vKChxIHmsf15h_ljLwIbip4_lRPyddPH28vr5qbL5-vLz_cNF4YszTa9J12gLpnnKF3aJjvhl4yw2XfMoleMui4gN6AVkp2gx86o3uve4ed9uKUvDv6bnP6Vrdd7DwWj9PkIqZdsbzVqhWHR1X07V_oXdrlenWlZKuNAAaqUvxI-ZxKyRjsNo9zPcwysIeg7DEoW4Oyj0HZh9r05sl61884_G75lUwFxBEoVYprzH9m_8f2J8U6oX0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2548930107</pqid></control><display><type>article</type><title>Influence of different physiological hemodynamics on fractional flow reserve values in the left coronary artery and right coronary artery</title><source>SpringerNature Journals</source><creator>Wada, Kensaku ; Fujii, Kenichi ; Horitani, Keita ; Kishimoto, Hiroshi ; Hashimoto, Kenta ; Shibutani, Hiroki ; Tsujimoto, Satoshi ; Matsumura, Koichiro ; Otagaki, Munemitsu ; Morishita, Shun ; Iwasaki, Masayoshi ; Shiojima, Ichiro</creator><creatorcontrib>Wada, Kensaku ; Fujii, Kenichi ; Horitani, Keita ; Kishimoto, Hiroshi ; Hashimoto, Kenta ; Shibutani, Hiroki ; Tsujimoto, Satoshi ; Matsumura, Koichiro ; Otagaki, Munemitsu ; Morishita, Shun ; Iwasaki, Masayoshi ; Shiojima, Ichiro</creatorcontrib><description>Background
Although the left coronary artery (LCA) has a flow profile in that most blood flow occurs during diastole rather than systole, the right coronary artery (RCA) has a flow pattern that is less diastolic dominant. This study assessed whether coronary pressure waveforms distal to stenoses with the same fractional flow reserve (FFR) was the same between the LCA and RCA.
Methods
A total of 347 vessels from 318 patients who underwent FFR measurements were included. Conventional FFR was calculated as the ratio of the mean coronary distal pressure (Pd) to the mean aortic pressure (Pa) at maximal hyperemia. The pressure drop ratios in systole (PDR
systole
) and diastole (PDR
diastole
) were calculated as the sum of (Pa minus Pd) divided by the sum of Pa at the intracoronary diastolic and systolic pressure phases, respectively.
Results
Analysis of covariance of the regression line of correlation between conventional FFR and PDR
systole
revealed that the slope was significantly greater in the RCA than in the left anterior descending artery (LAD) and left circumflex artery (LCX) (−0.765, −0.578, and −0.589,
p
< 0.001). On the other hand, the regression line of correlation between conventional FFR and PDR
diastole
found that the slope was significantly greater in the LAD and LCX than in the RCA (−1.349, −1.318, and −1.223,
p
< 0.001).
Conclusions
The pressure waveform distal to the stenosis differs between the LCA and RCA. In the LCA, the decrease in diastolic pressure mainly contributed to the drop in FFR, whereas in the RCA, it was the decrease in systolic pressure.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-021-01797-z</identifier><identifier>PMID: 33550427</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Aorta ; Biomedical Engineering and Bioengineering ; Blood flow ; Blood pressure ; Blood vessels ; Cardiac Surgery ; Cardiology ; Coronary artery ; Coronary vessels ; Diastole ; Diastolic pressure ; Flow distribution ; Hemodynamics ; Hyperemia ; Mathematical analysis ; Medicine ; Medicine & Public Health ; Original Article ; Pressure drop ; Stenosis ; Stents ; Systole ; Systolic pressure ; Vascular Surgery ; Veins & arteries ; Waveforms</subject><ispartof>Heart and vessels, 2021-08, Vol.36 (8), p.1125-1131</ispartof><rights>Springer Japan KK, part of Springer Nature 2021</rights><rights>Springer Japan KK, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-89b68a0e8b121ecae91c6db51925b415ec5106230b9087756dcd698bc8bae68c3</citedby><cites>FETCH-LOGICAL-c399t-89b68a0e8b121ecae91c6db51925b415ec5106230b9087756dcd698bc8bae68c3</cites><orcidid>0000-0001-7721-2990</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00380-021-01797-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00380-021-01797-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33550427$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wada, Kensaku</creatorcontrib><creatorcontrib>Fujii, Kenichi</creatorcontrib><creatorcontrib>Horitani, Keita</creatorcontrib><creatorcontrib>Kishimoto, Hiroshi</creatorcontrib><creatorcontrib>Hashimoto, Kenta</creatorcontrib><creatorcontrib>Shibutani, Hiroki</creatorcontrib><creatorcontrib>Tsujimoto, Satoshi</creatorcontrib><creatorcontrib>Matsumura, Koichiro</creatorcontrib><creatorcontrib>Otagaki, Munemitsu</creatorcontrib><creatorcontrib>Morishita, Shun</creatorcontrib><creatorcontrib>Iwasaki, Masayoshi</creatorcontrib><creatorcontrib>Shiojima, Ichiro</creatorcontrib><title>Influence of different physiological hemodynamics on fractional flow reserve values in the left coronary artery and right coronary artery</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>Background
Although the left coronary artery (LCA) has a flow profile in that most blood flow occurs during diastole rather than systole, the right coronary artery (RCA) has a flow pattern that is less diastolic dominant. This study assessed whether coronary pressure waveforms distal to stenoses with the same fractional flow reserve (FFR) was the same between the LCA and RCA.
Methods
A total of 347 vessels from 318 patients who underwent FFR measurements were included. Conventional FFR was calculated as the ratio of the mean coronary distal pressure (Pd) to the mean aortic pressure (Pa) at maximal hyperemia. The pressure drop ratios in systole (PDR
systole
) and diastole (PDR
diastole
) were calculated as the sum of (Pa minus Pd) divided by the sum of Pa at the intracoronary diastolic and systolic pressure phases, respectively.
Results
Analysis of covariance of the regression line of correlation between conventional FFR and PDR
systole
revealed that the slope was significantly greater in the RCA than in the left anterior descending artery (LAD) and left circumflex artery (LCX) (−0.765, −0.578, and −0.589,
p
< 0.001). On the other hand, the regression line of correlation between conventional FFR and PDR
diastole
found that the slope was significantly greater in the LAD and LCX than in the RCA (−1.349, −1.318, and −1.223,
p
< 0.001).
Conclusions
The pressure waveform distal to the stenosis differs between the LCA and RCA. In the LCA, the decrease in diastolic pressure mainly contributed to the drop in FFR, whereas in the RCA, it was the decrease in systolic pressure.</description><subject>Aorta</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Blood flow</subject><subject>Blood pressure</subject><subject>Blood vessels</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Coronary artery</subject><subject>Coronary vessels</subject><subject>Diastole</subject><subject>Diastolic pressure</subject><subject>Flow distribution</subject><subject>Hemodynamics</subject><subject>Hyperemia</subject><subject>Mathematical analysis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Pressure drop</subject><subject>Stenosis</subject><subject>Stents</subject><subject>Systole</subject><subject>Systolic pressure</subject><subject>Vascular Surgery</subject><subject>Veins & arteries</subject><subject>Waveforms</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1DAUhS0EokPbF2CBLLFhE3ptx7G9RBXQSpXYlLXlONczqRJ7sDNF0zfgrfF0CkggsbqL891zfw4hrxm8ZwDqogAIDQ1w1gBTRjUPz8iKdUw2XCrxnKzAMGi04OqEvCrlDoBJw8xLciKElNBytSI_rmOYdhg90hToMIaAGeNCt5t9GdOU1qN3E93gnIZ9dPPoC02Rhuz8MqZYpTCl7zRjwXyP9N5Vr0LHSJcN0gnDQn3Klct76vKChxIHmsf15h_ljLwIbip4_lRPyddPH28vr5qbL5-vLz_cNF4YszTa9J12gLpnnKF3aJjvhl4yw2XfMoleMui4gN6AVkp2gx86o3uve4ed9uKUvDv6bnP6Vrdd7DwWj9PkIqZdsbzVqhWHR1X07V_oXdrlenWlZKuNAAaqUvxI-ZxKyRjsNo9zPcwysIeg7DEoW4Oyj0HZh9r05sl61884_G75lUwFxBEoVYprzH9m_8f2J8U6oX0</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Wada, Kensaku</creator><creator>Fujii, Kenichi</creator><creator>Horitani, Keita</creator><creator>Kishimoto, Hiroshi</creator><creator>Hashimoto, Kenta</creator><creator>Shibutani, Hiroki</creator><creator>Tsujimoto, Satoshi</creator><creator>Matsumura, Koichiro</creator><creator>Otagaki, Munemitsu</creator><creator>Morishita, Shun</creator><creator>Iwasaki, Masayoshi</creator><creator>Shiojima, Ichiro</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7721-2990</orcidid></search><sort><creationdate>20210801</creationdate><title>Influence of different physiological hemodynamics on fractional flow reserve values in the left coronary artery and right coronary artery</title><author>Wada, Kensaku ; Fujii, Kenichi ; Horitani, Keita ; Kishimoto, Hiroshi ; Hashimoto, Kenta ; Shibutani, Hiroki ; Tsujimoto, Satoshi ; Matsumura, Koichiro ; Otagaki, Munemitsu ; Morishita, Shun ; Iwasaki, Masayoshi ; Shiojima, Ichiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-89b68a0e8b121ecae91c6db51925b415ec5106230b9087756dcd698bc8bae68c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aorta</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Blood flow</topic><topic>Blood pressure</topic><topic>Blood vessels</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Coronary artery</topic><topic>Coronary vessels</topic><topic>Diastole</topic><topic>Diastolic pressure</topic><topic>Flow distribution</topic><topic>Hemodynamics</topic><topic>Hyperemia</topic><topic>Mathematical analysis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Pressure drop</topic><topic>Stenosis</topic><topic>Stents</topic><topic>Systole</topic><topic>Systolic pressure</topic><topic>Vascular Surgery</topic><topic>Veins & arteries</topic><topic>Waveforms</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wada, Kensaku</creatorcontrib><creatorcontrib>Fujii, Kenichi</creatorcontrib><creatorcontrib>Horitani, Keita</creatorcontrib><creatorcontrib>Kishimoto, Hiroshi</creatorcontrib><creatorcontrib>Hashimoto, Kenta</creatorcontrib><creatorcontrib>Shibutani, Hiroki</creatorcontrib><creatorcontrib>Tsujimoto, Satoshi</creatorcontrib><creatorcontrib>Matsumura, Koichiro</creatorcontrib><creatorcontrib>Otagaki, Munemitsu</creatorcontrib><creatorcontrib>Morishita, Shun</creatorcontrib><creatorcontrib>Iwasaki, Masayoshi</creatorcontrib><creatorcontrib>Shiojima, Ichiro</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wada, Kensaku</au><au>Fujii, Kenichi</au><au>Horitani, Keita</au><au>Kishimoto, Hiroshi</au><au>Hashimoto, Kenta</au><au>Shibutani, Hiroki</au><au>Tsujimoto, Satoshi</au><au>Matsumura, Koichiro</au><au>Otagaki, Munemitsu</au><au>Morishita, Shun</au><au>Iwasaki, Masayoshi</au><au>Shiojima, Ichiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of different physiological hemodynamics on fractional flow reserve values in the left coronary artery and right coronary artery</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>36</volume><issue>8</issue><spage>1125</spage><epage>1131</epage><pages>1125-1131</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><abstract>Background
Although the left coronary artery (LCA) has a flow profile in that most blood flow occurs during diastole rather than systole, the right coronary artery (RCA) has a flow pattern that is less diastolic dominant. This study assessed whether coronary pressure waveforms distal to stenoses with the same fractional flow reserve (FFR) was the same between the LCA and RCA.
Methods
A total of 347 vessels from 318 patients who underwent FFR measurements were included. Conventional FFR was calculated as the ratio of the mean coronary distal pressure (Pd) to the mean aortic pressure (Pa) at maximal hyperemia. The pressure drop ratios in systole (PDR
systole
) and diastole (PDR
diastole
) were calculated as the sum of (Pa minus Pd) divided by the sum of Pa at the intracoronary diastolic and systolic pressure phases, respectively.
Results
Analysis of covariance of the regression line of correlation between conventional FFR and PDR
systole
revealed that the slope was significantly greater in the RCA than in the left anterior descending artery (LAD) and left circumflex artery (LCX) (−0.765, −0.578, and −0.589,
p
< 0.001). On the other hand, the regression line of correlation between conventional FFR and PDR
diastole
found that the slope was significantly greater in the LAD and LCX than in the RCA (−1.349, −1.318, and −1.223,
p
< 0.001).
Conclusions
The pressure waveform distal to the stenosis differs between the LCA and RCA. In the LCA, the decrease in diastolic pressure mainly contributed to the drop in FFR, whereas in the RCA, it was the decrease in systolic pressure.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>33550427</pmid><doi>10.1007/s00380-021-01797-z</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-7721-2990</orcidid></addata></record> |
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| source | SpringerNature Journals |
| subjects | Aorta Biomedical Engineering and Bioengineering Blood flow Blood pressure Blood vessels Cardiac Surgery Cardiology Coronary artery Coronary vessels Diastole Diastolic pressure Flow distribution Hemodynamics Hyperemia Mathematical analysis Medicine Medicine & Public Health Original Article Pressure drop Stenosis Stents Systole Systolic pressure Vascular Surgery Veins & arteries Waveforms |
| title | Influence of different physiological hemodynamics on fractional flow reserve values in the left coronary artery and right coronary artery |
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