Impact of Hydrostatic Pressure Variations Caused by Height Differences in Supine and Prone Positions on Fractional Flow Reserve Values in the Coronary Circulation
Objectives. To examine the influence of hydrostatic pressure on fractional flow reserve (FFR) in vivo. Background. Systematic differences in FFR values have been observed previously in the left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA). It has be...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2019/4532862 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849695713525497856 |
|---|---|
| author | Yoshitaka Kawaguchi Kazuki Ito Humihiko Kin Yusuke Shirai Ayako Okazaki Keisuke Miyajima Tomoyuki Watanabe Mariko Tatsuguchi Yasushi Wakabayashi Yuichiro Maekawa |
| author_facet | Yoshitaka Kawaguchi Kazuki Ito Humihiko Kin Yusuke Shirai Ayako Okazaki Keisuke Miyajima Tomoyuki Watanabe Mariko Tatsuguchi Yasushi Wakabayashi Yuichiro Maekawa |
| author_sort | Yoshitaka Kawaguchi |
| collection | DOAJ |
| description | Objectives. To examine the influence of hydrostatic pressure on fractional flow reserve (FFR) in vivo. Background. Systematic differences in FFR values have been observed previously in the left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA). It has been suggested that as the hydrostatic pressure variations caused by the height differences between the catheter tip (mean aortic pressure (Pa)) and pressure-wire sensor (mean distal intracoronary pressure (Pd)) are small, intracoronary pressure need not be corrected. Methods. Resting Pd/Pa and FFR values in 23 patients (27 lesions) were measured and compared in supine and prone positions. These values were corrected by hydrostatic pressure influenced by height levels and compared. Height differences between Pa and Pd were calculated using coronary computed tomography angiographies. Results. In LAD, resting Pd/Pa and FFR values were significantly higher in the prone position than in the supine position (0.97 ± 0.05 vs 0.89 ± 0.04, P<0.001 (resting Pd/Pa); 0.81 ± 0.09 vs 0.72 ± 0.07, P<0.001 (FFR)). Conversely, in LCX and RCA, these values were significantly lower in the prone position (LCX: 0.93 ± 0.03 vs 0.98 ± 0.03, P<0.001 (resting Pd/Pa); 0.84 ± 0.05 vs 0.89 ± 0.04, P<0.001 (FFR); RCA: 0.91 ± 0.04 vs 0.98 ± 0.03, P=0.005 (resting Pd/Pa); 0.78 ± 0.07 vs 0.84 ± 0.07, P=0.019 (FFR)). FFR values corrected by hydrostatic pressure showed good correlations in the supine and prone positions (R2 = 0.948 in LAD; R2 = 0.942 in LCX; R2 = 0.928 in RCA). Conclusions. Hydrostatic pressure variations due to height levels influence intracoronary pressure measurements and largely affect resting Pd/Pa and FFR, which might have caused systematic differences in FFR values between the anterior and posterior coronary territories. |
| format | Article |
| id | doaj-art-cdc7b0841b2646cfa2312af13b65ab26 |
| institution | DOAJ |
| issn | 0896-4327 1540-8183 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-cdc7b0841b2646cfa2312af13b65ab262025-08-20T03:19:41ZengWileyJournal of Interventional Cardiology0896-43271540-81832019-01-01201910.1155/2019/45328624532862Impact of Hydrostatic Pressure Variations Caused by Height Differences in Supine and Prone Positions on Fractional Flow Reserve Values in the Coronary CirculationYoshitaka Kawaguchi0Kazuki Ito1Humihiko Kin2Yusuke Shirai3Ayako Okazaki4Keisuke Miyajima5Tomoyuki Watanabe6Mariko Tatsuguchi7Yasushi Wakabayashi8Yuichiro Maekawa9Department of Cardiology, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, JapanDepartment of Cardiology, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, JapanDepartment of Cardiology, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, JapanDepartment of Cardiology, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, JapanDepartment of Cardiology, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, JapanDepartment of Cardiology, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, JapanDepartment of Cardiology, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, JapanDepartment of Cardiology, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, JapanDepartment of Cardiology, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, JapanInternal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, JapanObjectives. To examine the influence of hydrostatic pressure on fractional flow reserve (FFR) in vivo. Background. Systematic differences in FFR values have been observed previously in the left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA). It has been suggested that as the hydrostatic pressure variations caused by the height differences between the catheter tip (mean aortic pressure (Pa)) and pressure-wire sensor (mean distal intracoronary pressure (Pd)) are small, intracoronary pressure need not be corrected. Methods. Resting Pd/Pa and FFR values in 23 patients (27 lesions) were measured and compared in supine and prone positions. These values were corrected by hydrostatic pressure influenced by height levels and compared. Height differences between Pa and Pd were calculated using coronary computed tomography angiographies. Results. In LAD, resting Pd/Pa and FFR values were significantly higher in the prone position than in the supine position (0.97 ± 0.05 vs 0.89 ± 0.04, P<0.001 (resting Pd/Pa); 0.81 ± 0.09 vs 0.72 ± 0.07, P<0.001 (FFR)). Conversely, in LCX and RCA, these values were significantly lower in the prone position (LCX: 0.93 ± 0.03 vs 0.98 ± 0.03, P<0.001 (resting Pd/Pa); 0.84 ± 0.05 vs 0.89 ± 0.04, P<0.001 (FFR); RCA: 0.91 ± 0.04 vs 0.98 ± 0.03, P=0.005 (resting Pd/Pa); 0.78 ± 0.07 vs 0.84 ± 0.07, P=0.019 (FFR)). FFR values corrected by hydrostatic pressure showed good correlations in the supine and prone positions (R2 = 0.948 in LAD; R2 = 0.942 in LCX; R2 = 0.928 in RCA). Conclusions. Hydrostatic pressure variations due to height levels influence intracoronary pressure measurements and largely affect resting Pd/Pa and FFR, which might have caused systematic differences in FFR values between the anterior and posterior coronary territories.http://dx.doi.org/10.1155/2019/4532862 |
| spellingShingle | Yoshitaka Kawaguchi Kazuki Ito Humihiko Kin Yusuke Shirai Ayako Okazaki Keisuke Miyajima Tomoyuki Watanabe Mariko Tatsuguchi Yasushi Wakabayashi Yuichiro Maekawa Impact of Hydrostatic Pressure Variations Caused by Height Differences in Supine and Prone Positions on Fractional Flow Reserve Values in the Coronary Circulation Journal of Interventional Cardiology |
| title | Impact of Hydrostatic Pressure Variations Caused by Height Differences in Supine and Prone Positions on Fractional Flow Reserve Values in the Coronary Circulation |
| title_full | Impact of Hydrostatic Pressure Variations Caused by Height Differences in Supine and Prone Positions on Fractional Flow Reserve Values in the Coronary Circulation |
| title_fullStr | Impact of Hydrostatic Pressure Variations Caused by Height Differences in Supine and Prone Positions on Fractional Flow Reserve Values in the Coronary Circulation |
| title_full_unstemmed | Impact of Hydrostatic Pressure Variations Caused by Height Differences in Supine and Prone Positions on Fractional Flow Reserve Values in the Coronary Circulation |
| title_short | Impact of Hydrostatic Pressure Variations Caused by Height Differences in Supine and Prone Positions on Fractional Flow Reserve Values in the Coronary Circulation |
| title_sort | impact of hydrostatic pressure variations caused by height differences in supine and prone positions on fractional flow reserve values in the coronary circulation |
| url | http://dx.doi.org/10.1155/2019/4532862 |
| work_keys_str_mv | AT yoshitakakawaguchi impactofhydrostaticpressurevariationscausedbyheightdifferencesinsupineandpronepositionsonfractionalflowreservevaluesinthecoronarycirculation AT kazukiito impactofhydrostaticpressurevariationscausedbyheightdifferencesinsupineandpronepositionsonfractionalflowreservevaluesinthecoronarycirculation AT humihikokin impactofhydrostaticpressurevariationscausedbyheightdifferencesinsupineandpronepositionsonfractionalflowreservevaluesinthecoronarycirculation AT yusukeshirai impactofhydrostaticpressurevariationscausedbyheightdifferencesinsupineandpronepositionsonfractionalflowreservevaluesinthecoronarycirculation AT ayakookazaki impactofhydrostaticpressurevariationscausedbyheightdifferencesinsupineandpronepositionsonfractionalflowreservevaluesinthecoronarycirculation AT keisukemiyajima impactofhydrostaticpressurevariationscausedbyheightdifferencesinsupineandpronepositionsonfractionalflowreservevaluesinthecoronarycirculation AT tomoyukiwatanabe impactofhydrostaticpressurevariationscausedbyheightdifferencesinsupineandpronepositionsonfractionalflowreservevaluesinthecoronarycirculation AT marikotatsuguchi impactofhydrostaticpressurevariationscausedbyheightdifferencesinsupineandpronepositionsonfractionalflowreservevaluesinthecoronarycirculation AT yasushiwakabayashi impactofhydrostaticpressurevariationscausedbyheightdifferencesinsupineandpronepositionsonfractionalflowreservevaluesinthecoronarycirculation AT yuichiromaekawa impactofhydrostaticpressurevariationscausedbyheightdifferencesinsupineandpronepositionsonfractionalflowreservevaluesinthecoronarycirculation |