Universität zu Köln

Wienemann, Hendrik, Meyer, Annika, Mauri, Victor, Baar, Till ORCID: 0000-0002-6744-1463, Adam, Matti, Baldus, Stephan and Halbach, Marcel (2021). Comparison of Resting Full-Cycle Ratio and Fractional Flow Reserve in a German Real-World Cohort. Front. Cardiovasc. Med., 8. LAUSANNE: FRONTIERS MEDIA SA. ISSN 2297-055X

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Abstract

Objective: The aim of this study was to evaluate non-hyperemic resting pressure ratios (NHPRs), especially the novel resting full-cycle ratio (RFR; lowest pressure distal to the stenosis/aortic pressure during the entire cardiac cycle), compared to the gold standard fractional flow reserve (FFR) in a real-world setting.Methods: The study included patients undergoing coronary pressure wire studies at one German University Hospital. No patients were excluded based on any baseline or procedural characteristics, except for insufficient quality of traces. The diagnostic performance of four NHPRs vs. FFR <= 0.80 was tested. Morphological characteristics of stenoses were analyzed by quantitative coronary angiography.Results: 617 patients with 712 coronary lesions were included. RFR showed a significant correlation with FFR (r = 0.766, p < 0.01). Diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of RFR were 78% (95% confidence interval = 75; 81), 72% (65; 78), 81% (77; 84), 63% (57; 69), and 86% (83; 89). Relevant predictors for discordance of RFR <= 0.89/FFR > 0.8 were LAD lesions, peripheral artery disease, age, female sex and non-focal stenoses. Predictors for discordance of RFR > 0.89/FFR <= 0.8 included non-LCX lesions, percent diameter stenosis and previous percutaneous coronary intervention in the target vessel. RFR and all other NHPRs were highly correlated with each other.Conclusion: All NHPRs have a similar correlation with the gold standard FFR and may facilitate the acceptance and implementation of physiological assessments of lesion severity. However, we found ~20% discordant results between NHPRs and FFR in our all-comers German cohort.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wienemann, Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, Annika UNSPECIFIED UNSPECIFIED UNSPECIFIED Mauri, Victor UNSPECIFIED UNSPECIFIED UNSPECIFIED Baar, Till UNSPECIFIED orcid.org/0000-0002-6744-1463 UNSPECIFIED Adam, Matti UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Halbach, Marcel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-569440
DOI:	10.3389/fcvm.2021.744181
Journal or Publication Title:	Front. Cardiovasc. Med.
Volume:	8
Date:	2021
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	2297-055X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language WAVE-FREE RATIO; CORONARY-ARTERY-DISEASE; MICROVASCULAR DYSFUNCTION; STENOSIS SEVERITY; SEX-DIFFERENCES; FOLLOW-UP; ADENOSINE; PCI; REVASCULARIZATION; DISCORDANCE Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56944