Comparison between Fractional Flow Reserve and Visual Assessment by Multiple Observers in Patients with Moderate Coronary Artery Lesions

Abstract

Objectives: Our aim was to evaluate whether more than one observer or fractional flow reserve has the same re­sults in assessing coronary lesion severity in intermediate lesions. Methods: Our hospital’s database was searched for frac­tional flow reserve procedures and then these patient’s lesions were assessed visually by three experienced in­terventional cardiologist. Results: 8 of 46 patients were (17.4%) female and 38 of 46 were (82,6%) male. Average age was 61±11 years (Male: 60±11 / Female: 70±7 years). One observer could only detect 66.7% of severe lesions and 76.2% of non-severe lesions. When two observers agreed about lesion sever­ity, true detection of severe lesions was (max) 76.7%, and true detection of non-severe lesions was (max) 66.7%, so a decrease in true detection of non-severe lesions was observed. When one of the observers called a lesion “se­vere” and the lesion was assumed as “severe”, detection of a severe lesion was 83.3% (p=0.017); if all of the ob­servers agreed that the lesion was “non-severe” then true detection of a non-severe lesion was 90.5% (p<0.05). Conclusion: One observer can’t detect a lesion sever­ity sufficiently, but when three observers’ information was evaluated, there was nearly 90% concordance with frac­tional flow reserve results.