Aims. The aim of this study was to assess the safety and diagnostic efficacy of frequency-domain optical coherence tomography (FD-OCT) in identifying functional severity of the left main coronary artery (LM) stenosis determined by fractional flow reserve (FFR). Methods and Results. 101 patients with LM lesion (20–70% diameter stenosis angiographically) underwent FFR measurement and FD-OCT imaging of the LM. The following parameters were measured by FD-OCT in the LM: reference lumen area (RLA), reference lumen diameter (RLD), minimum lumen area (MLA), minimum lumen diameter (MLD), % lumen area stenosis, and % diameter stenosis. The LM lesions were analyzable by FD-OCT in 88/101 (87.1%) patients. FFR at maximum hyperemia was ≤0.80 in 39/88 (44.3%) patients. FFR values were correlated significantly with FD-OCT-derived LM lumen parameters. An MLA cutoff value of 5.38 mm² had the highest sensitivity and specificity of 82% and 81%, respectively, followed by an MLD of 2.43 mm (sensitivity 77%, specificity 72%) and AS of 60% (sensitivity 72%, specificity 72%) for predicting FFR <0.80. Conclusions. FD-OCT is a safe and feasible imaging technique for the assessment of LM stenosis. An FD-OCT-derived MLA of ≤5.38 mm² strongly predicts the functional severity of an LM lesion.

中文翻译：

---

频域光学相干断层扫描预测功能显着左冠状动脉狭窄的诊断性能

目标。本研究的目的是评估频域光学相干断层扫描 (FD-OCT) 在识别由血流储备分数 (FFR) 确定的左冠状动脉主干 (LM) 狭窄的功能严重程度方面的安全性和诊断效果。方法和结果. 101 名 LM 病变患者（20-70% 的直径狭窄血管造影）接受了 LM 的 FFR 测量和 FD-OCT 成像。通过 FD-OCT 在 LM 中测量以下参数：参考管腔面积 (RLA)、参考管腔直径 (RLD)、最小管腔面积 (MLA)、最小管腔直径 (MLD)、% 管腔面积狭窄和 % 直径狭窄. 88/101 (87.1%) 名患者可通过 FD-OCT 分析 LM 病变。在 39/88 (44.3%) 的患者中，最大充血时的 FFR ≤0.80。FFR 值与 FD-OCT 衍生的 LM 流明参数显着相关。MLA 截断值 5.38 mm ²的灵敏度和特异性最高，分别为 82% 和 81%，其次是 MLD 为 2.43 mm（灵敏度 77%，特异性 72%）和 AS 为 60%（灵敏度 72%，特异性72%) 用于预测 FFR <0.80。结论。FD-OCT 是评估 LM 狭窄的一种安全可行的成像技术。FD-OCT 衍生的 MLA ≤5.38 mm ²强烈预测 LM 病变的功能严重程度。