Intracoronary electrocardiogram ST segment shift evaluation during intravenous XXXX infusion: a comparison with fractional flow reserve.

@entity1 @entity308 @entity859 @entity741 @entity850
BACKGROUND: By measuring the pressure decline caused by coronary narrowing, fractional flow reserve (FFR) is an index of the physiological significance of a @entity850 . Intracoronary electrocardiogram (IC-ECG) recording from an angioplasty guidewire is more sensitive than standard ECG in detecting regional @entity741 . The aim of the study was to assess if unipolar IC-ECG ST segment recording from angioplasty guidewire during maximal pharmacologic vasodilation could be used as an indirect estimation of FFR results. METHODS: Forty-eight clinically stable @entity1 with intermediate @entity850 underwent FFR evaluation and IC-ECG recording during intravenous @entity859 infusion. RESULTS: FFR values were  <= 0.80 in 26 (54%) @entity1 and > 0.80 in 22 (46%). After @entity859 , standard ECG was abnormal in only nine (19%) @entity1 , while IC-ECG showed a significant ST segment shift (IST) in 24 (50%) @entity1 : ST elevation in 19 @entity1 and @entity308 in five). IST was documented in 21/26 @entity1 with FFR  <= 0.80 (81%) and in 3/22 with FFR > 0.80 (p < 0.001). Sensitivity of IST for predicting an abnormal FFR value was 81%, specificity 86%, positive and negative predictive accuracies were 88% and 79%, respectively. CONCLUSIONS: Intracoronary ST segment shift evaluation during @entity859 infusion may be of value in assessing the functional significance of a borderline @entity850 . The presence of IST during @entity859 infusion could obviate the need for additional FFR evaluation.
