For a better treatment of coronary artery disease in a catheterization lab, detection of the relative contributions of the epicardial stenosis (ES) and concomitant microvascular disease (MVD) is important. To diagnose ES, fractional flow reserve (FFR), the hyperemic stenosis resistance index (hSRv) and to diagnose MVD, hyperemic microvascular resistance index (hMRv) have been tested in cath labs. However, for concurrent assessment of ES and MVD, functional parameter utilizing flow and pressure values, pressure drop coefficient (CDP) and combined functional and anatomical parameter, lesion flow coefficient (LFC) are defined. To test the ability of CDP and LFC to account for ES and MVD, they were correlated with the hSRv and hMRv. We hypothesize that CDP and LFC will have a better combined correlation with hSRv and hMRv.

Simultaneous pressure and flow readings were obtained in 11 Yorkshire swine. Single and multiple linear regression analyses were conducted between the FFR, CDP and LFC vs hSRv and hMRv. The correlation coefficient (r) was used to check the strength of correlation.

The individual correlation between hSRv and hMRV with CDP (r = 0.90; r = 0.78) and LFC (r = 0.89; r = 0.95) was stronger compared to FFR (r = 0.63; r = 0.32). The combined correlation between hSRv and hMRv with CDP (r = 0.95) and LFC (r = 0.95) increased from the individual correlation. Therefore, we conclude that CDP and LFC can diagnose ES and MVD concurrently and might prove to be improved diagnostic parameters than FFR.

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