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Fig 1.

Study population.

CCS, chronic coronary syndrome; FFR, fractional flow reserve; DPV, diastolic peak velocity; LAD, left anterior descending artery; OCT, optical coherence tomography; PCI, percutaneous coronary intervention; S-TDE, stress-transthoracic Doppler echocardiography.

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Fig 1 Expand

Fig 2.

Optical coherence tomography findings.

A lipidic plaque had a region with strong signal attenuation and diffuse border. Layered plaque was defined as a layer of tissue located close to the luminal surface with clear demarcation from the underlying lipidic plaque (A) or non-lipidic plaque (B).

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Fig 2 Expand

Fig 3.

Changes in hyperemic DPV after PCI.

(A) Overall hyperemic DPV increased after PCI for LAD. (B) Distribution of % hyperemic DPV increase after PCI. Overall, 19% (20/103) patients exhibited % hyperemic DPV decrease. DPV, diastolic peak velocity; PCI, percutaneous coronary intervention.

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Fig 3 Expand

Table 1.

Clinical demographics and angiographic findings.

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Table 1 Expand

Fig 4.

Relationship between preprocedural physiological parameters and % hyperemic DPV increase.

Percent hyperemic DPV increase was inversely associated with preprocedural fractional flow reserve (A) and hyperemic DPV (B). DPV, diastolic peak velocity.

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Fig 4 Expand

Table 2.

Physiological parameters.

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Table 2 Expand

Fig 5.

Association between the number of layered plaques and % hyperemic DPV increase.

The greater the number of layered plaques in the vessel, the more frequent % hyperemic DPV decrease was observed. DPV, diastolic peak velocity.

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Fig 5 Expand

Table 3.

Optical coherence tomography findings.

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Table 3 Expand

Fig 6.

Percent hyperemic DPV increase according to the preprocedural optical coherence tomography and S-TDE findings.

Percent hyperemic DPV increase was significantly lower in vessels with layered plaques (A) and in vessels with high preprocedural hyperemic DPV (B). DPV, diastolic peak velocity; PCI, percutaneous coronary intervention; S-TDE, stress-transthoracic Doppler echocardiography.

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Fig 6 Expand

Fig 7.

Prevalence of hyperemic coronary flow decrease.

The prevalence of coronary flow decrease in the four groups was categorized by the presence of layered plaque and the best cutoff value of preprocedural hyperemic DPV. DPV, diastolic peak velocity.

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Fig 7 Expand

Table 4.

Predictors of coronary hyperemic DPV decrease after percutaneous coronary intervention.

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Table 4 Expand

Table 5.

Predictors of higher-level coronary hyperemic DPV increase after PCI (>50% increase).

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Table 5 Expand