Coronary Physiology Quiz

How to check for 'drift' in coronary physiology measurement?

• After the measurement, pull wire back to the aortic guiding catheter

• Check Pd/Pa ratio is still 1.00 (0.98-1.02 acceptable)

• Check aortic pressure trace

• Never act on decision before drift check

• All of the above

NHPR class 1 in ESC guidelines for the diagnosis and management of chronic coronary syndromes 2024 is :

• DFR

• FFR

• RFR

• iFR

• Pd/Pa

Fractional flow reserve (FFR) is :

• the ratio of pressure distal to a stenotic lesion to normal pressure in the same vessel

• Maximum achievable blood flow in stenotic coronary artery multiplied by Maximum blood flow in the same artery without stenosis

• Ratio of maximum coronary blood flow to resting coronary blood flow

• Minimum achievable blood flow in stenotic coronary artery divided by minimum blood flow in the same artery without stenosis

• Maximum achievable blood flow in stenotic coronary artery divided by Maximum blood flow in the same artery without stenosis

Inoca diagnosis if there is no obstructive epicardial disease and …

• FFR .< 0.80 or NHPR > 0.89

• FFR < 0.80 and NHPR < 0.89

• FFR > 0.80 or NHPR > 0.89

• FFR > 0.80 and NHPR > 0.89

• None of all above

A 62-year-old male underwent an elective coronary angiogram. An FFR was performed on a lesion in his LAD. The FFR mean value was 0.85 in the LAD vessel following IC injection of 200 microgramms adenosine. What does this FFR result signify?

• adenosine dose was insufficient

• non-viable myocardium

• non-flow limiting stenosis of the coronary artery

• the coronary vessel should be stented

• the coronary vessel should undergo bypass grafting

Which type of coronary lesion will be more beneficial to undergo PCI?

• Long and diffuse lesion

• Focal coronary lesion

• Heavily calcified coronary lesion

• Serial coronary lesion

• All of the above

Two clinical trials that shown non-inferiority of iFR compare to FFR are :

• FAME-1 & FAME-2

• iFR SWEDEHEART & DEFINE-FLAIR

• DEFER & FAME-1

• DEFER & FAME-2

• iFR SWEDEHEART & DEFER

What is the goal of giving Nitrate before measuring intracoronary iFR?

• To decrease aortic pressure

• To prevent epicardial spasm

• To achieve maximum vessel hyperemia

• To prevent slow coronary blood flow

• None of the above

Causes of low post-PCI FFR, except :

• Diffuse lesion

• Focal lesion

• Stent under expansion

• Serial lesion

• None of the above

Statement below are true regarding coronary physiology measurement, except :

• Removing needle introducer before measuring iFR value is a must

• When 'equalizing or normalizing', pressure wire should be placed inside the guide catheter

• Never use guide catheter with a side hole

• Adenosine dose for RCA is 100 mcg