Chhatriwalla Adnan K, Ragosta Michael, Powers Eric R, Sarembock Ian J, Gimple Lawrence W, Fischer Joshua J, Barringhaus Kurt G, Kramer Christopher M, Samady Habib
Cardiovascular Division, Department of Medicine, University of Virginia Health Systems, Charlottesville, Virginia, USA.
J Invasive Cardiol. 2006 Nov;18(11):544-9.
To demonstrate that fractional flow reserve (FFR) of vessels in patients with high left ventricular mass index (LVMI) should be similar to that of matched vessels in patients with normal LVMI.
FFR is a physiologic index of coronary lesion severity. It is not known whether FFR remains useful in the setting of increased LVMI, when microvascular abnormalities may be present.
LVMI was calculated in 84 patients using contrast left ventriculography after validation with cardiac magnetic resonance imaging. Cardiac risk factors, LV ejection fraction (LVEF), minimal lumen diameter (MLD), percent diameter stenosis (%DS), lesion length and FFR were compared in 22 patients with high LVMI to 62 patients with normal LVMI and angiographically-matched vessels.
LVMI was 126 +/- 21 g/m2 in the high LVMI group and 84 +/- 21 g/m2 in the normal LVMI group. There were no differences in age, LVEF, diabetes, hypertension or dyslipidemia between groups. Angiographic lesion characteristics were well matched in patients with high versus normal LVMI (MLD 1.3 +/- 0.6 mm vs. 1.3 +/- 0.6 mm, %DS 61 +/- 13% vs. 62 +/- 13%, and lesion length 14.2 +/- 7.0 mm vs. 14.3 +/- 7.0 mm; p = NS for all). Importantly, no difference in FFR was observed (0.79 +/- 0.12 vs. 0.78 +/- 0.16; p = NS) between the groups, and LVMI did not correlate with FFR in a multivariate analysis.
FFR of coronary lesions in patients with high LVMI is no different than FFR of angiographically-matched lesions in patients with normal LVMI, suggesting that high LV mass should not limit the utility of FFR as an index of coronary lesion severity.
证明左心室质量指数（LVMI）高的患者血管的血流储备分数（FFR）应与LVMI正常的匹配患者血管的FFR相似。
FFR是冠状动脉病变严重程度的生理指标。当可能存在微血管异常时，FFR在LVMI增加的情况下是否仍然有用尚不清楚。
在84例患者中，经心脏磁共振成像验证后，使用对比剂左心室造影计算LVMI。比较22例LVMI高的患者与62例LVMI正常且血管造影匹配的患者的心脏危险因素、左心室射血分数（LVEF）、最小管腔直径（MLD）、直径狭窄百分比（%DS）、病变长度和FFR。
LVMI高的组中LVMI为126±21 g/m²，LVMI正常的组中为84±21 g/m²。两组之间在年龄、LVEF、糖尿病、高血压或血脂异常方面无差异。LVMI高与正常的患者血管造影病变特征匹配良好（MLD 1.3±0.6 mm对1.3±0.6 mm，%DS 61±13%对62±13%，病变长度14.2±7.0 mm对14.3±7.0 mm；所有p值均为无统计学差异）。重要的是，两组之间未观察到FFR有差异（0.79±0.12对0.78±0.16；p =无统计学差异），并且在多变量分析中LVMI与FFR不相关。
LVMI高的患者冠状动脉病变的FFR与LVMI正常且血管造影匹配的病变的FFR无差异，表明左心室质量高不应限制FFR作为冠状动脉病变严重程度指标的效用。
