Fractional flow reserve (FFR) measurement was compared to dobutamine stress echocardiography (DSE) instable angina (SA) with stable coronary lesion (s) (SCL (s) ) in a few trials; however, similar comparisons in patients with acute coronary syndrome (ACS) with non-culprit lesion (s) (NCL (s) ) are lacking. Our objectives were to prospectively evaluate the diagnostic performance of FFR with two different cutoff values (< 0.80 and < 0.75) relative to DSE in moderate (30%-70% diameter stenosis) NCLs (ACS group) and to compare these observations with those measured in SCLs (SA group). One hundred seventy-five consecutive patients with SA (n = 86) and ACS (n = 89) with 225 coronary lesions (109 SCLs and 116 NCLs) were enrolled. In contrast to the ACS cohort in SA patients, normal DSE was associated with higher FFR values compared to those with abnormal DSE (P = 0.051 versus P = 0.006). In addition, in the SA group, a significant correlation was observed between DSE (regional wall motion score index at peak stress) and FFR (r = −0.290; P = 0.002), whereas a similar association was absent (r = −0.029; P = 0.760) among ACS patients. In the SA group, decreasing the FFR cutoff value (< 0.80 versus < 0.75) improved the concordance of FFR with DSE (70.6% versus 81.7%) without altering its discriminatory power (area under the curve; 0.68 versus 0.63; P = 0.369), whereas in the ACS group, concordance remained similar (69.0% versus 71.6%) and discriminatory power decreased (0.62 versus 0.51; P = 0.049), respectively. In conclusion, lesion-specific FFR assessment may have different relevance in patients with moderate NCLs than in patients with SCLs.

在一些试验中，将血流储备分数 (FFR) 测量与多巴酚丁胺负荷超声心动图 (DSE) 不稳定型心绞痛 (SA) 与稳定冠状病变 (s) (SCL (s) ) 进行了比较；然而，缺乏对具有非罪犯病变 (s) (NCL (s) ) 的急性冠状动脉综合征 (ACS) 患者的类似比较。我们的目标是前瞻性地评估 FFR 在中度（30%-70% 直径狭窄）NCL（ACS 组）中相对于 DSE 的两个不同临界值（< 0.80 和 < 0.75）的诊断性能，并将这些观察结果与测量结果进行比较在 SCL（SA 组）中。175 名连续患有 SA ( n = 86) 和 ACS ( n= 89) 有 225 个冠状动脉病变（109 个 SCL 和 116 个 NCL）。与 SA 患者的 ACS 队列相比，与异常 DSE 的患者相比，正常的 DSE 与更高的 FFR 值相关（P = 0.051 vs P = 0.006）。此外，在 SA 组中，观察到 DSE（峰值应力时的区域壁运动评分指数）和 FFR 之间存在显着相关性（r = -0.290；P = 0.002），而没有类似的关联（r = -0.029；磷= 0.760) 在 ACS 患者中。在 SA 组中，降低 FFR 截止值（< 0.80 对 < 0.75）改善了 FFR 与 DSE 的一致性（70.6% 对 81.7%），而不会改变其判别力（曲线下面积；0.68 对 0.63；P = 0.369） ，而在 ACS 组中，一致性保持相似（69.0% 对 71.6%），辨别力分别下降（0.62 对 0.51；P = 0.049）。总之，与 SCL 患者相比，中度 NCL 患者的病灶特异性 FFR 评估可能具有不同的相关性。