When performing coronary angiography in a stable situation, the identification of an intermediate coronary lesion (between 50 and 70%) is common, and requires additional functional evaluation. The gold standard for this evaluation is Fractional Flow Reserve (FFR). FFR is a flow ratio transformed into a pressure ratio by simplification, neglecting some parameters, especially microcirculatory resistance. The aim of this study is to investigate hemodynamic and structural assessment induced in specific conditions, and their repercussion on functional assessment by FFR to implement the diagnostic approach and personalize it for each patient.
Study Type
OBSERVATIONAL
Enrollment
400
Chu Brest
Brest, France
Index of Microcirculatory Resistance (IMR)
IMR = Pd x Tmn at maximal hyperhemia Normal range \< 25
Time frame: During coronary angiography
Fractional Flow Reserve (FFR)
FFR = Pd/Pa at maximal hyperhemia Normal value \> 0.80
Time frame: During coronary angiography
Coronary Flow Reserve (CFR)
CFR = Hyperhemic flow / Resting flow Normal value \> 2
Time frame: During coronary angiography
Resting Full cycle Ratio (RFR)
Lowest Pd/Pa value in systole and diastole (mean of 5 consecutive cardiac cycles) Normal value \> 0.80
Time frame: During coronary angiography
Quantitative Flow Ratio (QFR)
Normal value \> 0.80
Time frame: During coronary angiography
Angio-IMR
Estimated hyperemic Pa × angio-FFR × \[vessel length/(K × Vdiastole)\] Normal value \< 25
Time frame: During coronary angiography
Death
Time frame: 12 months
Angina pectoris (CCS)
Grade I : Angina with strenuous or rapid or prolonged exertion at work or recreation Grade II : Slight limitation of ordinary activity Grade III : Marked limitation of ordinary physical activity Grade IV : Inability to carry on any physical activity without discomfort, anginal syndrome may be present at rest
Time frame: 12 months
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