Heart and Vessels

, Volume 34, Issue 2, pp 208–217 | Cite as

Comparison between minimum lumen cross-sectional area and intraluminal ultrasonic intensity analysis using integrated backscatter intravascular ultrasound for prediction of functionally significant coronary artery stenosis

  • Hironori Takami
  • Shinjo SonodaEmail author
  • Yoshitaka Muraoka
  • Toshiya Miura
  • Akiyoshi Shimizu
  • Reo Anai
  • Yoshinori Sanuki
  • Tetsu Miyamoto
  • Yasushi Oginosawa
  • Yoshihisa Fujino
  • Yuki Tsuda
  • Masaru Araki
  • Yutaka Otsuji
Original Article


Intravascular ultrasound (IVUS)-derived minimum lumen cross-sectional area (MLA) is useful to predict myocardial ischemia using fractional flow reserve (FFR). Recent studies reported an increase in the intraluminal ultrasonic integrated backscatter (IB) value using IVUS across the coronary artery stenosis (CAS) was significantly correlated with FFR. However, these details have not been fully understood. We evaluated the utility of intraluminal IB analysis for predicting myocardial ischemia based on FFR measurements by comparing that with conventional IVUS-derived MLA. A total of 65 patients with 75 intermediate lesions underwent both FFR and IB-IVUS simultaneously were analyzed. We measured IVUS-derived MLA and intraluminal IB value at the coronary ostial site, 5 mm distal site to the CAS, and far distal site, which is the same as the position of the pressure wire sensor. The increase in IB values was calculated as the distal IB value − the ostial IB value (focal ∆IB) and the far distal IB value − the ostial IB value (total ∆IB). MLA did not show a significant correlation with FFR (p = 0.13); however, focal ∆IB and total ∆IB showed significant correlations with FFR (p = 0.008 and p < 0.001, respectively). The receiver operating characteristic curve analysis shows that the best cut-off value of focal ∆IB and total ∆IB was 8 and 14, respectively. Although the diagnostic abilities to predict FFR ≤ 0.75 among IVUS-derived MLA ≤ 3.0 mm2, focal ∆IB ≥ 8, and total ∆IB ≥ 14 were similar, a multivariate analysis showed that total ∆IB was the most useful index (p < 0.001). In conclusion, total ∆IB, which is measured at the same as the position of FFR measurement, might be useful for functional assessment of intermediate CAS.


Coronary artery stenosis Integrated backscatter intravascular ultrasound Fractional flow reserve Minimum lumen area 



We have no financial or other relations that could lead to conflict of interest.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interest.


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Copyright information

© Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  • Hironori Takami
    • 1
  • Shinjo Sonoda
    • 1
    Email author
  • Yoshitaka Muraoka
    • 1
  • Toshiya Miura
    • 1
  • Akiyoshi Shimizu
    • 1
  • Reo Anai
    • 1
  • Yoshinori Sanuki
    • 1
  • Tetsu Miyamoto
    • 1
  • Yasushi Oginosawa
    • 1
  • Yoshihisa Fujino
    • 2
  • Yuki Tsuda
    • 1
  • Masaru Araki
    • 1
  • Yutaka Otsuji
    • 1
  1. 1.Second Department of Internal MedicineUniversity of Occupational and Environmental HealthKitakyushuJapan
  2. 2.Department of Environmental EpidemiologyUniversity of Occupational and Environmental HealthKitakyushuJapan

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