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Revista Colombiana de Cardiología
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Inicio Revista Colombiana de Cardiología Caracterización clínica y hemodinámica de pacientes sometidos a medición de ...
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Vol. 20. Núm. 6.
Páginas 355-362 (noviembre - diciembre 2013)
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Vol. 20. Núm. 6.
Páginas 355-362 (noviembre - diciembre 2013)
Open Access
Caracterización clínica y hemodinámica de pacientes sometidos a medición de la reserva de flujo fraccional en la Fundación Abood Shaio entre 2010–2011. Primera experiencia en Colombia
Clinical and hemodynamic characterization of patients who underwent measurement of fractional flow reserve in Abood-Shaio Foundation between 2010–2011. First experience in Colombia
Visitas
2001
Luis Gutiérrez1,
Autor para correspondencia
gjaikel@hotmail.com

Correspondencia: Servicio de Cardiología, Hospital México, San José, Costa Rica. Teléfono: (506) 2242–6646.
, Gilberto Estrada2, Luis I. Calderón2, Pablo Castro2, Edgar Hurtado2
1 Hospital México. San José, Costa Rica
2 Fundación Abood-Shaio, Bogotá, Colombia
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Información del artículo
Introducción y objetivos

la valoración fisiológica de las lesiones coronarias mediante la medición de la reserva de flujo fraccional, se asocia con revascularizacion fisiológica en lugar de anatómica sin incremento de los eventos cardiovasculares en el seguimiento y semejante libertad de angina. El objetivo es caracterizar la primera población estudiada a través de la medición de la reserva de flujo fraccional en Colombia, en la Fundación Abood-Shaio.

Métodos

En los años 2010–2011 se estudiaron 50 pacientes y 60 lesiones coronarias, a través de la medición de la reserva de flujo fraccional; 68% de los pacientes se estudiaron por síndromes coronarios agudos. En 94% de los casos la indicación de la valoración fisiológica fueron lesiones intermedias, 4% lesiones ostiales y 2% enfermedad coronaria multivaso.

La media de reserva de flujo fraccional fue de 0,87 (DS±0,075); de la totalidad de la muestra 11,6% de pacientes tuvo reserva de flujo fraccional menor de 0,80 y se les realizó angioplastia de la lesión evaluada, siendo mayor de 0,80 en 88,4%.

Conclusión

La valoración fisiológica de las lesiones coronarias mediante reserva de flujo fraccional fue menor de 0,80 en 11,6% de los casos, evitando la angioplastia coronaria en 88,4% de las lesiones evaluadas.

Palabras clave:
angioplastia coronaria
revascularización
síndrome coronario agudo
Introduction and objectives

The physiological assessment of coronary lesions through measurement of fractional flow reserve is associated with functional revascularization without increasing mortality and myocardial infarction in follow-up and with reduction of angina. The first objective of the study is to characterize the first population studied by measuring the fractional flow reserve in Colombia, Fundación Abood-Shaio.

Methods

In the years 2010–2011 we studied 50 patients and 60 coronary lesions measuring the fractional flow reserve. 68% of these patients were studied by angiography for acute coronary syndromes. The indication of the physiological assessment in 94% of the cases were intermediate lesions, 4% were ostial and 2% were multivessel coronary disease.

Mean fractional flow reserve (FFR) was 0.87 (SD±0.075); from the total sample 11,6% of patients had a fractional flow reserve of less than 0.80 and underwent angioplasty of the evaluated lesion, being greater than 0.80 in 88,4% of the patients.

Conclusion

The physiological assessment of coronary lesions using fractional flow reserve was less than 0.80 in 11,6% of cases, avoiding coronary angioplasty in 88.4% of the lesions evaluated.

Keywords:
coronary angioplasty
revascularization
acute coronary syndrome
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Bibliografía
[1.]
G.J. Bech, B. DeBruyne, N.H. Pijls, et al.
Fractional flow reserve to determine the appropriateness of angioplasty in moderate coronary stenosis: a randomized trial.
Circulation, 103 (2001), pp. 2928-2934
[2.]
N.H. Pijls, P. Van Schaardenburgh, G. Manoharan, et al.
Percutaneous coronary intervention of funcionally non-significant stenoses: 5-year follow-up of the DEFER study.
J Am Coll Cardiol, 49 (2007), pp. 2105-2111
[3.]
B.K. Koo, H.J. Kang, T.J. Youn, et al.
Physiologic assessment of jailed side branch lesions using fractional flow reserve.
J Am Coll Cardiol, 46 (2005), pp. 633-637
[4.]
A. Ziaee, W.A. Parham, S.C. Herrmann, et al.
Lack of relation between imaging and physiology in ostial coronary artery narrowings.
Am J Cardiol, 93 (2004), pp. 1404-1407
[5.]
N.H. Pijls, W.F. Fearon, P.A. Tonino, et al.
Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease: 2-year follow-up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) study.
J Am Coll Cardiol, 56 (2010), pp. 177-184
[6.]
A. Berger, K.J. Botman, P.A. MacCarthy, et al.
Long- term clinical outcome after fractional flow reserve guided percutaneous coronary intervention in patients with multivessel disease.
J Am Coll Cardiol, 46 (2005), pp. 438-442
[7.]
G.J. Bech, H. Droste, N.H. Pijls, et al.
Value of fractional flow reserve in making decisions about bypass surgery for equivocal left main coronary artery disease.
Heart, 86 (2001), pp. 547-552
[8.]
M. Hamilos, O. Muller, T. Cuisset, et al.
Long-term clinical outcome after fractional flow reserve guided treatment in patients with angiographically equivocal left main coronary artery stenosis.
Circulation, 120 (2009), pp. 1505-1512
[9.]
W.B. Meijboom, C.A. Van Mieghem, N. van Pelt, et al.
Comprehensive assessment of coronary artery stenoses: computed tomography coronary angiography versus conventional coronary angiography and correlation with fractional flow reserve in patients with stable angina.
J Am Coll Cardiol, 52 (2008), pp. 636-643
[10.]
J.A. Spaan, J.J. Piek, J.I. Hoofman, et al.
Physiological basis of clinically used coronary hemodynamic indices.
Circulation, 113 (2006), pp. 446-455
[11.]
N. Melikinan, F. Del Furia, C. Di Mario.
Phisiologic lesion assesment during percutaneous coronary intervention.
Cardiol Clin, 28 (2010), pp. 31-54
[12.]
N.H. Pijls, B. Van Gelder, P. Van der Voort, et al.
Fractional flow reserve: a useful index to evaluate the influence of an epicardial coronary stenosis on myocardial blood flow.
Circulation, 92 (1995), pp. 318-319
[13.]
N.H. Pijls, B. Van Gelder, P. Van der Voort, et al.
Fractional flow reserve. A useful index to evaluate the influence of an epicardial coronary stenosis on myocardial blood flow.
Circulation, 92 (1995), pp. 3183-3193
[14.]
N.H. Pijls, B. De Bruyne, K. Peels, et al.
Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses.
N Engl J Med, 334 (1996), pp. 1703-1708
[15.]
B. De Bruyne, J. Bartunek, S.U. Sys, et al.
Relation between myocardial fractional flow reserve calculated from coronary pressure measurements and exerciseinduced myocardial ischemia.
Circulation, 92 (1995), pp. 39-46
[16.]
J. Bartunek, E. Van Schuerbeeck, B. de Bruyne.
Comparison of exercise electrocardiography and dobutamine echocardiography with invasively assessed myocardial fractional flow reserve in evaluation of severity of coronary arterial narrowing.
Am J Cardiol, 79 (1997), pp. 478-481
[17.]
O. Caymaz, A.S. Fak, H. Tezcan, et al.
Correlation of myocardial fractional flow reserve with thallium-201 SPECT imaging in intermediate-severity coronary artery lesions.
J Invasive Cardiol, 12 (2000), pp. 345-350
[18.]
W.F. Fearon, A. Takagi, A. Jeremias, et al.
Use of fractional myocardial flow reserve to assess the functional significance of intermediate coronary stenoses.
Am J Cardiol, 86 (2000), pp. 1013-1014
[19.]
M. Jiménez-Navarro, J. Alonso-Briales, M.J. Hernández García.
Measurement of fractional flow reserve to assess moderately severe coronary lesions: correlation with dobutamine stress echocardiography.
J Interv Cardiol, 14 (2001), pp. 499-504
[20.]
B. De Bruyne, N.H.J. Pijls, J. Bartunek, et al.
Fractional flow reserve in patients with prior myocardial infarction.
Circulation, 104 (2001), pp. 157-162
[21.]
H. Yanagisawa, T. Chikamori, N. Tanaka, et al.
Correlation between thallium-201 myocardial perfusion defects and the functional severity of coronary artery stenosis as assessed by pressure-derived myocardial fractional flow reserve.
Circ J, 66 (2002), pp. 1105-1109
[22.]
Y. Usui, T. Chikamori, H. Yanagisawa, et al.
Reliability of pressure-derived myocardial fractional flow reserve in assessing coronary artery stenosis in patients with previous myocardial infarction.
Am J Cardiol, 92 (2003), pp. 699-702
[23.]
M.J. Kern, A. Lerman, J.W. Bech, et al.
Physiological assessment of coronary artery disease in the cardiac catheterization laboratory: a scientific statement from the American Heart Association Committee on Diagnostic and Interventional Cardiac Catheterization.
Circulation, 114 (2006), pp. 1321-1341
[24.]
N. Melikian, T. Cuisset, M. Hamilos, et al.
Fractional flow reserve the influence of the collateral circulation.
Int J Cardiol, 132 (2009), pp. 109-110
[25.]
M. Botman, N.H. Pijls, J.W. Bech, et al.
Percutaneous coronary intervention or bypass surgery in multivessel disease? A tailored approach based on coronary pressure measurement.
Catheter Cardiovasc Interv, 63 (2004), pp. 184-191
[26.]
M.A. Christou, G.C. Siontis, D.G. Katritsis, et al.
Metaanalysis of fractional flow reserve versus quantitative coronary angiography and noninvasive imaging for evaluation of myocardial ischemia.
Am J Cardiol, 99 (2007), pp. 450-456
[27.]
P.A. Tonino, B. DeBruyne, N.H. Pijls, et al.
Fractional flow reserve versus angiography for guiding percutaneous coronary intervention.
N Engl J Med, 360 (2009), pp. 213-224
[28.]
P.A.L. Tonino, W.F. Fearon, B. De Bruyne, et al.
Angiographic versus functional severity of coronary artery stenoses in the FAME study, fractional flow reserve versus angiography in multivessel evaluation.
J Am Coll Cardiol, 55 (2010), pp. 2816-2821
[29.]
A. Berger, K.J. Botman, P.A. MacCarthy, et al.
Long- term clinical outcome after fractional flow reserve- guided percutaneous coronary intervention in patients with multivessel disease.
J Am Coll Cardiol, 46 (2005), pp. 438-442
[30.]
G.J. Bech, H. Droste, N.H. Pijls, et al.
Value of fractional flow reserve in making decisions about bypass surgery for equivocal left main coronary artery disease.
Heart, 86 (2001), pp. 547-552
[31.]
B. De Bruyne, N.H. Pijls, G.R. Heyndrickx, et al.
Pressure-derived fractional flow reserve to assess serial epicardial stenoses: theoretical basis and animal validation.
Circulation, 101 (2000), pp. 1840-1847
[32.]
B. DeBruyne, N.H.J. Pijls, J. Bartunek, et al.
Fractional flow reserve in patients with prior myocardial infarction.
Circulation, 104 (2001), pp. 157-162
[33.]
M.A. Leesar, T. Abdul-Baki, N.I. Akkus, et al.
Use of fractional flow reserve versus stress perfusion scintigraphy after unstable angina. Effect on duration of hospitalization, cost, procedural characteristics, and clinical outcome.
J Am Coll Cardiol, 41 (2003), pp. 1115-1121
[34.]
J.M. Potvin, J. Rodés-Cabau, O.F. Bertrand, et al.
Usefulness of fractional flow reserve measurements to defer revascularization in patients with stable or unstable angina pectoris, non-ST-elevation and ST-elevation acute myocardial infarction, or atypical chest pain.
Am J Cardiol, 98 (2006), pp. 289-297
[35.]
J.J. Fischer, X.Q. Wang, H. Samady, et al.
Outcome of patients with acute coronary syndromes and moderate lesions undergoing deferral of revascularization based on fractional flow reserve assessment.
Catheter Cardiovasc Interv, 68 (2006), pp. 544-548
[36.]
A. Yong, N. Austin, D. Brieger, M. Lowe, L. Kritharides.
Three-dimensional and twodimensional quantitative coronary angiography, and their prediction of reduced fractional flow reserve.
Eur Heart J, 32 (2011), pp. 345-353
[37.]
J.J. Fischer, H. Samady, J.A. McPherson, I.J. Sarembock, E.R. Powers, L.W. Gimple, M. Ragosta.
Comparison between visual assessment and quantitative angiography versus fractional flow reserve for native coronary narrowings of moderate severity.
Am J Cardiol, 90 (2002), pp. 210-215
[38.]
P. Agostoni, G. Biondi-Zoccai, G. Van Langenhove, K. Cornelis, P. Vermeersch, C. Convens, et al.
Comparison of assessment of native coronary arteries by standard versus three- dimensional coronary angiography.
Am J Cardiol, 102 (2008), pp. 272-279
Copyright © 2013. Sociedad Colombiana de Cardiología y Cirugía Cardiovascular
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