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Chapter 24. Adjunctive Diagnostic Techniques: Fractional Flow Reserve

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Which statement is correct with respect to the derivation of fractional flow reserve (FFR)?

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A. During maximal vasodilation, resistance is maximized and flow becomes proportional to pressure.

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B. In a normal epicardial vessel, there is little pressure loss along its course (ie, distal pressure is similar to proximal pressure).

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C. FFR is calculated as the proximal coronary or aortic pressure divided by the distal coronary pressure during maximal hyperemia.

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D. FFR is defined as the maximum flow in a diseased vessel compared to the maximum flow in an adjacent nondiseased vessel.

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E. FFR is defined as maximal flow down the vessel divided by resting flow down the vessel.

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The correct answer is B

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Which of the following is a feature of fractional flow reserve (FFR)?

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A. It has a normal value of less than 0.80.

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B. It is affected by changes in heart rate and blood pressure.

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C. It is an index specific for epicardial coronary disease.

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D. It has an ischemic cutoff value at 1.0.

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E. It has high variability and is not very reproducible.

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The correct answer is C

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Which of the following is true when measuring fractional flow reserve (FFR)?

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A. The sensor is positioned just beyond the stenosis and not in the distal two-thirds of the vessel.

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B. Nitroglycerin is not routinely administered.

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C. The optimal dose of intracoronary adenosine is 12 micrograms (μg) for the right coronary artery and 16 μg for the left coronary artery.

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D. It is important to keep the guide catheter well-seated when assessing an aorto-ostial coronary stenosis.

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E. A continuous intravenous administration of adenosine has the advantage of allowing a slow pullback of the pressure sensor to identify the location of the most significant pressure drop.

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The correct answer is E

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The FFR versus Angiography for Multivessel Evaluation (FAME) trial did which of the following?

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A. Compared fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) to angiography-guided coronary PCI in patients with stable, single-vessel coronary disease.

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