Prediction of the physiologic severity of coronary lesions using 3D IVUS: Validation by direct coronary pressure measurements

This study was performed to determine whether three-dimensional intravascul ar ultrasound (3D IVUS) could predict the physiologic significance of coron ary lesions. Seventeen lesions were evaluated by means of 30 IVUS, pressure measurements, and quantitative coronary angiography, Physiologic parameter s were calculated from the 3D IVUS measures using established equations and compared to values measured by pressure guidewire, IVUS minimum lumen area (MLA) correlated with fractional flow reserve (FFR; R-2 = 0.55, P = 0.003) and pressure gradient (R-2 = 0.52, P = 0.003). Lesion length (L) had a pos itive correlation with pressure gradient (R-2 = 0.45, P = 0.007). By multiv ariate analysis, the only significant independent determinant of FFR was ML A/L measured by IVUS. The IVUS-predicted pressure gradient acid FFR were we ll correlated with values measured directly (R-2 = 0.88, P < 0.001; R-2 = 0 .90, P < 0.001, respectively), The physiologic severity of coronary lesions is primarily influenced by lumen area and lesion length and can be establi shed by 3D IVUS. Cathet Cardiovasc Intervent 2001;53:48-55, (C) 2001 Wiley- Liss Inc.