Diagnostic accuracy of intraluminal blood speckle intensity on intravascular ultrasound for physiological assessment of coronary artery stenosis

作者：Saito Yuichi^*; Kitahara Hideki; Nakayama Takashi; Fujimoto Yoshihide; Kobayashi Yoshio

来源：Coronary Artery Disease, 2017, 28(2): 145-150.

DOI：10.1097/MCA.0000000000000457

• coronary artery disease
• fractional flow reserve
• intravascular ultrasound

Objectives The difference in intraluminal intensity of blood speckle (IBS) on integrated backscatter intravascular ultrasound (IVUS) across the coronary stenosis was reportedly correlated with fractional flow reserve (FFR) in the left descending coronary artery. The aim of this study was to investigate the novel physiological assessment using IVUS in all coronary arteries.
Patients and methods Fifty-four patients with 57 coronary lesions underwent both FFR and IVUS. Intraluminal IBS was analyzed using integrated backscatter IVUS in crosssections at the ostium and the distal site of the target vessel Delta IBS was calculated as: (distal IBS)-(ostium IBS).
Results Both.IBS (r=-0.50, P< 0.01) and minimum lumen area (MLA) (r= 0.55, P< 0.01) showed significant correlations with FFR. There were significant correlations between FFR and.IBS in the right and left descending coronary arteries (r=-0.60, P= 0.02, and r=-0.58, P< 0.01), but not in the left circumflex (r= 0.30, P= 0.44). In receiver operating characteristic curve analyses,Delta IBS predicted FFR less than or equal to 0.80 (area under the curve= 0.82, P< 0.01, best cutoff value= 6.78), as with MLA (area under the curve= 0.83, P< 0.01, best cutoffvalue=2.38). FFR progressively decreased in association with Delta IBS greater than or equal to 6.78 and MLA less than or equal to 2.38, and was the lowest when these were combined.
Conclusion Delta IBS was correlated with FFR in right and left descending coronary arteries. IVUS may assess coronary artery stenosis anatomically and physiologically.

• 出版日期2017-3