2 Department of Cardiology, General Hospital of Nikea-Piraeus, Nikaia, Greece.
2 Department of Internal Medicine, University of Athens, Attikon Hospital, Athens, Greece.
J Interv Cardiol. 2021 Nov 15;2021:7108284. doi: 10.1155/2021/7108284. eCollection 2021.
The aim of this study was to assess the safety and diagnostic efficacy of frequency-domain optical coherence tomography (FD-OCT) in identifying functional severity of the left main coronary artery (LM) stenosis determined by fractional flow reserve (FFR).
101 patients with LM lesion (20-70% diameter stenosis angiographically) underwent FFR measurement and FD-OCT imaging of the LM. The following parameters were measured by FD-OCT in the LM: reference lumen area (RLA), reference lumen diameter (RLD), minimum lumen area (MLA), minimum lumen diameter (MLD), % lumen area stenosis, and % diameter stenosis. The LM lesions were analyzable by FD-OCT in 88/101 (87.1%) patients. FFR at maximum hyperemia was ≤0.80 in 39/88 (44.3%) patients. FFR values were correlated significantly with FD-OCT-derived LM lumen parameters. An MLA cutoff value of 5.38 mm had the highest sensitivity and specificity of 82% and 81%, respectively, followed by an MLD of 2.43 mm (sensitivity 77%, specificity 72%) and AS of 60% (sensitivity 72%, specificity 72%) for predicting FFR <0.80.
FD-OCT is a safe and feasible imaging technique for the assessment of LM stenosis. An FD-OCT-derived MLA of ≤5.38 mm strongly predicts the functional severity of an LM lesion.
本研究旨在评估频域光相干断层扫描（FD-OCT）在识别由血流储备分数（FFR）确定的左主干冠状动脉（LM）狭窄的功能严重程度方面的安全性和诊断效能。
101 例 LM 病变患者（血管造影 20-70%直径狭窄）接受了 FFR 测量和 LM 的 FD-OCT 成像。FD-OCT 在 LM 中测量了以下参数：参考管腔面积（RLA）、参考管腔直径（RLD）、最小管腔面积（MLA）、最小管腔直径（MLD）、管腔面积狭窄百分比和管腔直径狭窄百分比。88/101（87.1%）例患者的 LM 病变可进行 FD-OCT 分析。39/88（44.3%）例患者最大充血时的 FFR≤0.80。FFR 值与 FD-OCT 衍生的 LM 管腔参数显著相关。MLA 的截断值为 5.38mm 时，预测 FFR<0.80 的敏感性和特异性最高，分别为 82%和 81%，其次是 MLD 为 2.43mm（敏感性 77%，特异性 72%）和 AS 为 60%（敏感性 72%，特异性 72%）。
FD-OCT 是评估 LM 狭窄的一种安全可行的成像技术。FD-OCT 衍生的 MLA≤5.38mm 强烈预测 LM 病变的功能严重程度。
