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Chapter 24. Adjunctive Diagnostic Techniques: Fractional Flow Reserve

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

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

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

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

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

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

The correct answer is B

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

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

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

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

D. It has an ischemic cutoff value at 1.0.

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

The correct answer is C

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

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

B. Nitroglycerin is not routinely administered.

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

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

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.

The correct answer is E

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

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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