Lesion eccentricity and fractional flow reserve and coronary flow reserve in coronary arteries

Fractional flow reserve has shown to be a gold standard in assessment of functional significance of coronary artery stenosis. Lesion eccentricity is an important geometric parameter which may affect the translational hemodynamics. Three dimensional quantitative coronary angiography (3D-QCA) was used to reconstruct the proximal or mid left anterior descending artery of 56 patients. The fractional flow reserve (FFR) was measured using pressure–temperature sensor guidewire and the effects of lesion eccentricity (EI) was investigated on the correlation between FFR diameter stenosis (DS), area stenosis (AS), minimum lumen diameter (MLD) and minimum lumen area (MLA). A linear regression analysis showed a non-significant correlation between FFR and DS, AS, MLD and MLA. In order to improve the correlations, a receiver operating characteristic (ROC) curve analysis was used to identify the best cut-off value of eccentricity to predict FFR ≤ 0.75. It was found that for lesions whose eccentricity is above the cut-off, the correlations are significant; however, the correlations are weak for lesions with eccentricity below the cut-off.