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Article Type

Article

Subject Area

Cardiology

Abstract

Background Myocardial perfusion imaging (MPI) is noninvasive test used for evaluation of functional significance of borderline coronary artery lesions. Moreover, instantaneous wave-free ratio (IFR) is a well-validated invasive method used for the same purpose. Objectives To compare the results of MPI and IFR in detection of ischemia in patients with single intermediate coronary artery lesion. Patients and methods A total of 60 patients with single intermediate coronary artery stenosis, visually judged as angiographic stenosis more than or equal to 50% and less than 70% during coronary angiography, were included. After coronary angiography, all patients were subjected to MPI and IFR at National Heart Institute between February 2018 and February 2020. IFR value less than or equal to 0.89 was considered significant, indicating functionally significant lesion, and IFR value more than or equal to 0.89 was considered insignificant, indicating functionally insignificant lesion. MPI results were considered positive when the defect size more than or equal to 10% in the territory of the affected vessel. Results Among 60 patients, 37 (61.7%) patients showed significant IFR value and 23 (38.3%) patients showed insignificant IFR value. Of 37 patients with significant IFR value, 30 (81.1%) patients showed positive MPI results and seven (18.9%) patients showed negative MPI results. Of 23 patients with insignificant IFR value, 19 (82.6%) patients showed negative MPI results, and four (17.4%) patients showed positive MPI results. So, there was good (kappa = 0.62), significant (P = 0.001) agreement between the MPI and IFR results. The sensitivity was 81.1%, the specificity was 82.6%, positive predictive value was 88.2%, the negative predictive value was 73.1%, and the accuracy was 81.7%. Conclusions MPI may be a valid alternative, noninvasive, less-expensive test than IFR for evaluation of functional significance of intermediate coronary artery lesions.

Keywords

Instantaneous wave-free ratio, myocardial perfusion imaging, coronary artery lesion

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