LETTER TO THE EDITOR
Fractional ﬂow reserve as an indicator of
coronary circulation with special reference to
Xaplanteris et al
reviewed physiological indicators via
catheterization to know the level of coronary circulation.
Among them, fractional ﬂow reserve (FFR) value has
been used for evaluating severity of coronary stenosis.
As there was no information on the relationship between
FFR and chronic kidney disease (CKD) in the article, I
present some references.
evaluated the effect of CKD on FFR
value in patients with intermediate coronary stenosis.
CKD was deﬁned as creatinine clearance value B45
ml/min, and FFR positive was deﬁned as B0.80.
Adjusted hazard ratios (HRs) (95% conﬁdence inter-
vals (CIs)) of diabetes and CKD for FFR positive were
1.07 (1.008-1.13) and 0.92 (0.87-0.97), respectively.
In contrast, Mohandas et al
reported a positive
relationship between renal function and FFR. A
standardized way of FFR measurements is important,
and inconsistent results on the relationship between
FFR and CKD would partly be explained by the pro-
cedure of measurement. Anyway, CKD information in
relation to FFR value should be conﬁrmed by further
There is no conﬂict of interest in this study.
Tomoyuki Kawada, MD,
Department of Hygiene and Public
Health, Nippon Medical School, 1-1-5
Sendagi, Bunkyo-Ku, Tokyo 113-8602,
1. Xaplanteris P, Barbato E, De Bruyne B. Catheter-based functional
metrics of the coronary circulation. J Nucl Cardiol. 2016. doi:
2. Tebaldi M, Biscaglia S, Fineschi M, Manari A, Menozzi M, Secco
GG, et al. Fractional ﬂow reserve evaluation and chronic kidney
disease: analysis from a multicenter Italian registry (the FREAK
Study). Catheter Cardiovasc Interv 2016;88:555-62.
3. Mohandas R, Segal MS, Huo T, Handberg EM, Petersen JW,
Johnson BD, et al. Renal function and coronary microvascular
dysfunction in women with symptoms/signs of ischemia. PLoS One
This Letter to the Editor is in response to a Review Article with doi:
J Nucl Cardiol 2017;24:1458.
Copyright Ó 2017 American Society of Nuclear Cardiology.