Tomaniak Mariusz, Ochijewicz Dorota, Kołtowski Łukasz, Rdzanek Adam, Pietrasik Arkadiusz, Jąkała Jacek, Slezak Magdalena, Malinowski Krzysztof P, Zaleska Martyna, Maksym Jakub, Barus Piotr, Roleder Tomasz, Filipiak Krzysztof J, Opolski Grzegorz, Kochman Janusz
First Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland.
Krakow Cardiovascular Research Institute, 30-055 Krakow, Poland.
J Clin Med. 2021 May 28;10(11):2379. doi: 10.3390/jcm10112379.
optical coherence tomography (OCT) might allow identifying lesion features reportedly associated with plaque vulnerability and increased risk of clinical events. Previous studies on correlation between OCT and functional lesion significance indices reported contradictory results, yet integration of complementary information from both modalities is gaining increased interest. The aim of the study was to compare plaque morphology using OCT in hemodynamically relevant vs. non-relevant lesions by fractional flow reserve (FFR).
consecutive patients with intermediate grade coronary stenoses by angiography were evaluated by both FFR and OCT in this single-center study. Stenoses were labeled hemodynamically relevant in case of the FFR ≤ 0.80. Minimal lumen area (MLA), fibrous cap thickness (FCT), minimal cap thickness over the calcium, angle of the calcium, and necrotic core within the lesions were evaluated.
a total of 105 patients (124 vessels) were analyzed. Of them, 65 patients were identified with at least one lesion identified as hemodynamically relevant by FFR (72 vessels, 58.1%). Lesions with FFR ≤0.80 presented with lower mean and minimal lumen area (3.46 ± 1.29 vs. 4.65 ± 2.19, =0.001 and 1.84 ± 0.97 vs. 2.66 ± 1.40, = 0.001) compared to patients with FFR > 0.80. No differences were found between groups in the mean and minimal FCT, mean, and maximal necrotic core, calcium angle, as well as the overall rate of calcified and lipid plaques.
hemodynamic relevance of intermediate grade lesions correlated moderately with the luminal assessment by OCT. No differences were identified in the plaque morphology between relevant and non-relevant coronary stenoses by FFR.
光学相干断层扫描（OCT）或许能够识别出据报道与斑块易损性及临床事件风险增加相关的病变特征。先前关于OCT与功能性病变严重程度指标之间相关性的研究报告了相互矛盾的结果，然而，整合来自这两种模式的互补信息正日益受到关注。本研究的目的是通过血流储备分数（FFR），使用OCT比较血流动力学相关病变与非相关病变的斑块形态。
在这项单中心研究中，对通过血管造影显示为中度冠状动脉狭窄的连续患者进行了FFR和OCT评估。若FFR≤0.80，则将狭窄标记为血流动力学相关。评估了病变内的最小管腔面积（MLA）、纤维帽厚度（FCT）、钙化上方的最小帽厚度、钙化角度和坏死核心。
共分析了105例患者（124支血管）。其中，65例患者被识别出至少有一个病变被FFR确定为血流动力学相关（72支血管，58.1%）。与FFR>0.80的患者相比，FFR≤0.80的病变平均管腔面积和最小管腔面积更低（分别为3.46±1.29 vs. 4.65±2.19，P = 0.001；1.84±0.97 vs. 2.66±1.40，P = 0.001）。两组在平均和最小FCT、平均和最大坏死核心、钙化角度以及钙化和脂质斑块的总体发生率方面未发现差异。
中度病变的血流动力学相关性与OCT的管腔评估中度相关。通过FFR，相关和非相关冠状动脉狭窄之间的斑块形态未发现差异。
