{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:51:02Z","timestamp":1792183862200,"version":"4.4.0"},"reference-count":21,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Coronary artery lesions (CALs) after Kawasaki disease present complex coronary hemodynamics. We investigated the relationship between coronary fractional flow reserve (FFR), myocardial flow reserve (MFR), and myocardial blood flow volume fraction (MBF) and their clinical usefulness in CALs after Kawasaki disease. Nineteen patients (18 men, 1 woman) who underwent cardiac catheterization and 13N-ammonia positron emission tomography, with 24 coronary artery branches, were included. Five branches had inconsistent FFR and MFR values, two had normal FFR but abnormal MFR, and three had abnormal FFR and normal MFR. The abnormal MFR group had significantly higher MBF at rest than the normal group (0.86 \u00b1 0.13 vs. 1.08 \u00b1 0.09, p = 0.001). The abnormal FFR group had significantly lower MBF at adenosine loading than the normal group (2.23 \u00b1 0.23 vs. 1.88 \u00b1 0.29, p = 0.021). The three branches with abnormal FFR only had stenotic lesions, but the MFR may have been normal because blood was supplied by collateral vessels. Combining FFR, MFR, and MBF will enable a more accurate assessment of peripheral coronary circulation and stenotic lesions in CALs and help determine treatment strategy and timing of intervention.<\/jats:p>","DOI":"10.3390\/jcdd11080229","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T11:06:42Z","timestamp":1721732802000},"page":"229","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hemodynamic Evaluation of Coronary Artery Lesions after Kawasaki Disease: Comparison of Fractional Flow Reserve during Cardiac Catheterization with Myocardial Flow Reserve during 13N-Ammonia PET"],"prefix":"10.3390","volume":"11","author":[{"given":"Makoto","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Nippon Medical School, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuji","family":"Fukazawa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nippon Medical School, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomonari","family":"Kiriyama","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nippon Medical School, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shogo","family":"Imai","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nippon Medical School, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryosuke","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nippon Medical School, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanae","family":"Shimada","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nippon Medical School, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nippon Medical School, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nippon Medical School, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nippon Medical School, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiro","family":"Kamisago","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nippon Medical School, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiko","family":"Itoh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nippon Medical School, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1253\/circj.CJ-19-1094","article-title":"JCS\/JSCS 2020 Guideline on Diagnosis and Management of Cardiovascular Sequelae in Kawasaki Disease","volume":"84","author":"Fukazawa","year":"2020","journal-title":"Circ. J."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Orenstein, J.M., Shulman, S.T., Fox, L.M., Baker, S.C., Takahashi, M., Bhatti, T.R., Russo, P.A., Mierau, G.W., De Chadar\u00e9vian, J.P., and Perlman, E.J. (2012). Three linked vasculopathic processes characterize Kawasaki disease: A light and transmission electron microscopic study. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0038998"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1536\/jhj.41.245","article-title":"Remodeling of coronary artery lesions due to Kawasaki disease: Comparison of arteriographic and immunohistochemical findings","volume":"41","author":"Atsuko","year":"2000","journal-title":"Jpn. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1016\/j.jacc.2007.01.087","article-title":"Percutaneous coronary intervention of functional nonsignificant stenosis: 5-year follow up of the DEFER study","volume":"49","author":"Pijls","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1056\/NEJMoa1205361","article-title":"Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease","volume":"367","author":"Pijls","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1161\/CIRCINTERVENTIONS.113.001049","article-title":"Physiological Basis and Long-Term Clinical Outcome of Discordance Between Fractional Flow Reserve and Coronary Flow Velocity Reserve in Coronary Stenoses of Intermediate Severity","volume":"7","author":"Damman","year":"2014","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e121","DOI":"10.1016\/j.nuclcard.2006.08.009","article-title":"Positron emission tomography myocardial perfusion and glucose metabolism imaging","volume":"13","author":"Machac","year":"2006","journal-title":"J. Nucl. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1093\/oxfordjournals.eurheartj.a014687","article-title":"The impact of myocardial blood flow quantitation with PET on the understanding of cardiac diseases","volume":"17","author":"Camici","year":"1996","journal-title":"Eur. Heart J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"273","DOI":"10.2967\/jnumed.117.201368","article-title":"Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC","volume":"59","author":"Murthy","year":"2018","journal-title":"J. Nucl. Med."},{"key":"ref_10","first-page":"e4","article-title":"2021 ACC\/AHA\/SCAI Guideline for Coronary Artery Revascularization: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"145","author":"Lawton","year":"2022","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1161\/01.CIR.87.4.1354","article-title":"Experimental basis of determining maximum coronary, myocardial, and collateral blood flow by pressure measurements for assessing functional stenosis severity before and after percutaneous transluminal coronary angioplasty","volume":"87","author":"Pijls","year":"1993","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.jacc.2003.10.032","article-title":"Estimation of myocardial hemodynamics before and after intervention in children with Kawasaki disease","volume":"43","author":"Ogawa","year":"2004","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/S0735-1097(97)00224-6","article-title":"From research to clinical practice: Current role of intracoronary physiologically based decision making in the cardiac catheterization laboratory","volume":"30","author":"Kern","year":"1997","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1016\/j.jcmg.2009.06.004","article-title":"Does coronary flow trump coronary anatomy?","volume":"2","author":"Gould","year":"2009","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.jjcc.2017.03.002","article-title":"Feasibility of PET for the management of coronary artery disease: Comparison between CFR and FFR","volume":"70","author":"Manabe","year":"2017","journal-title":"J. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.jcmg.2011.09.020","article-title":"Is discordance of coronary flow reserve and fractional flow reserve due to methodology or clinically relevant coronary pathophysiology?","volume":"5","author":"Johnson","year":"2012","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Tsuno, K., Fukazawa, R., Kiriyama, T., Imai, S., Watanabe, M., Kumita, S., and Itoh, Y. (2022). Peripheral Coronary Artery Circulatory Dysfunction in Remote Stage Kawasaki Disease Patients Detected by Adenosine Stress 13N-Ammonia Myocardial Perfusion Positron Emission Tomography. J. Clin. Med., 11.","DOI":"10.3390\/jcm11041134"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/0002-9149(74)90743-7","article-title":"Physiologic basis for assessing critical coronary stenosis. Instantaneous flow response and regional distribution during coronary hyperemia as measures of coronary flow reserve","volume":"33","author":"Gould","year":"1974","journal-title":"Am. J. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/cpf.12708","article-title":"Cardiac perfusion by positron emission tomography","volume":"41","author":"Nammas","year":"2021","journal-title":"Clin. Physiol. Funct. Imaging"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.1007\/s12350-020-02034-2","article-title":"Added value of myocardial blood flow using (18)F-flurpiridaz PET to diagnose coronary artery disease: The flurpiridaz 301 trial","volume":"28","author":"Moody","year":"2021","journal-title":"J. Nucl. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1955","DOI":"10.1007\/s12350-018-01476-z","article-title":"Comparison of diagnostic accuracy of PET-derived myocardial blood flow parameters: A meta-analysis","volume":"27","author":"Cho","year":"2020","journal-title":"J. Nucl. Cardiol."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/11\/8\/229\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:21:27Z","timestamp":1760109687000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/11\/8\/229"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,23]]},"references-count":21,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["jcdd11080229"],"URL":"https:\/\/doi.org\/10.3390\/jcdd11080229","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,23]]}}}