July 24, 2008Open Access
View Full PaperCoronary pressure never lies
Key Result
Fractional Flow Reserve (FFR) discrepancies with angiographic appearance were physiologically explained in 2 patients, highlighting reasons for apparent false positive or negative results.
Study Design
Type
Case Report (n=2)
Structured PICO
P
Population
Two patients with coronary stenosis and apparent or actual false positive or negative Fractional Flow Reserve (FFR) measurements.
E
Exposure
Fractional Flow Reserve (FFR) measurement
O
Outcome
Physiologic explanation for apparent or actual false positive or negative FFR
Apparent false positive or negative FFR results can often be explained by underlying physiologic conditions upon further examination.
Abstract
Fractional Flow Reserve (FFR), calculated by coronary pressure measurement, is the invasive gold standard to assess the hemodynamic significance of a coronary stenosis. FFR reliably indicates whether a stenosis is responsible for inducible ischemia and if percutaneous coronary intervention is appropriate. False positive or negative FFR is rare. Occasionally, however, a clinical or angiographic condition is encountered in which in first instance the FFR measurement contradicts the intuitive feeling of the interventionalist. Further examination in such cases, however, often reveals a clear physiologic explanation and in this manner FFR "lifts the veil". Two such patients are presented in this case report and the reasons for apparent or actual false positive or negative FFR are discussed.