Simultaneous Assessment of Fractional and Coronary Flow Reserves in Cardiac Transplant Recipients

• DOI: 10.1161/01.cir.0000091116.84926.6f
• Publication Date: 2003-09-09T02:19:36Z
• Authors: William F. Fearon; Mamoo Nakamura; David P. Lee; Mehrdad Rezaee; Randall H. Vagelos; Sharon A. Hunt; Peter J. Fitzgerald; Paul G. Yock; Alan C. Yeung
• Keywords: Fractional Flow Reserve; Intravascular Ultrasound; Coronary flow reserve

The utility of measuring fractional flow reserve (FFR) to assess cardiac transplant arteriopathy has not been evaluated. Measuring coronary (CFR) as well FFR could add information about the microcirculation, but until recently, this required two wires. We evaluated a new method for simultaneously and CFR with single wire investigate arteriopathy.In 53 cases asymptomatic recipients without angiographically significant disease, thermodilution-derived (CFRthermo) were measured same pressure in left anterior descending artery compared volumetric intravascular ultrasound (IVUS) imaging. average was 0.88+/-0.07; 75% cases, less than normal threshold 0.94; 15% < or =0.80, upper boundary gray zone ischemic threshold. There inverse correlation between IVUS-derived measures plaque burden, including percent volume (r=0.55, P<0.0001). CFRthermo 2.5+/-1.2; 47% =2.0. In 14%, (> =0.94) abnormal (<2.0), suggesting predominant microcirculatory dysfunction.FFR correlates IVUS findings is proportion patients angiograms. Simultaneous measurement wire, use novel thermodilution technique, feasible adds physiological evaluation these patients.