scholarly journals TCT-286 Quantitative Flow Ratio in Successfully Recanalized Total Occluded Vessels

2021 ◽  
Vol 78 (19) ◽  
pp. B117-B118
Author(s):  
Zheng Qiao ◽  
Rui Zhang ◽  
Changdong Guan ◽  
Lihua Xie ◽  
Zhongwei Sun ◽  
...  
Keyword(s):  
Flow Ratio ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

scholarly journals Feasibility and diagnostic reliability of quantitative flow ratio in the assessment of non-culprit lesions in acute coronary syndrome

2021 ◽  
Author(s):  
Aslihan Erbay ◽  
Lisa Penzel ◽  
Youssef S. Abdelwahed ◽  
Jens Klotsche ◽  
Anne-Sophie Schatz ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Performance ◽  
Primary Pci ◽  
Flow Ratio ◽  
Diagnostic Reliability ◽  
Index Procedure ◽  
Coronary Syndromes ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow ◽  
Good Agreement

AbstractSeveral studies have demonstrated the feasibility and safety of hemodynamic assessment of non-culprit coronary arteries in setting of acute coronary syndromes (ACS) using fractional flow reserve (FFR) measurements. Quantitative flow ratio (QFR), recently introduced as angiography-based fast FFR computation, has been validated with good agreement and diagnostic performance with FFR in chronic coronary syndromes. The aim of this study was to assess the feasibility and diagnostic reliability of QFR assessment during primary PCI. A total of 321 patients with ACS and multivessel disease, who underwent primary PCI and were planned for staged PCI of at least one non-culprit lesion were enrolled in the analysis. Within this patient cohort, serial post-hoc QFR analyses of 513 non-culprit vessels were performed. The median time interval between primary and staged PCI was 49 [42–58] days. QFR in non-culprit coronary arteries did not change between acute and staged measurements (0.86 vs 0.87, p = 0.114), with strong correlation (r = 0.94, p ≤ 0.001) and good agreement (mean difference -0.008, 95%CI -0.013–0.003) between measurements. Importantly, QFR as assessed at index procedure had sensitivity of 95.02%, specificity of 93.59% and diagnostic accuracy of 94.15% in prediction of QFR ≤ 0.80 at the time of staged PCI. The present study for the first time confirmed the feasibility and diagnostic accuracy of non-culprit coronary artery QFR during index procedure for ACS. These results support QFR as valuable tool in patients with ACS to detect further hemodynamic relevant lesions with excellent diagnostic performance and therefore to guide further revascularisation therapy.

Diagnostic performance and clinical implications for enhancing a hybrid quantitative flow ratio and fractional flow reserve revascularization decision making strategy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Peper ◽  
R.W Van Hamersvelt ◽  
B.J.M.W Rensing ◽  
J.P Van Kuijk ◽  
M Voskuil ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Hybrid Approach ◽  
High Accuracy ◽  
Intermediate Zone ◽  
Flow Ratio ◽  
Fractional Flow ◽  
Hybrid Strategy ◽  
Flow Reserve ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Abstract Background Fractional flow reserve (FFR) adoption persists low mainly due to procedural and operator related factors as well as costs. An alternative for FFR, quantitative flow ratio (QFR) achieves a high accuracy mainly outside the intermediate zone without the need for hyperemia and wire-use. Currently, no outcome trials assess the role of QFR in the guidance of revascularization. Therefore, we evaluate a QFR-FFR hybrid strategy in which FFR is measured inside of the intermediate zone. Methods This retrospective multi-center study included consecutive patients who underwent both invasive coronary angiography and FFR in the participating centers. QFR was calculated for all vessels in which FFR was measured. Diagnostic performance of QFR was assessed using an FFR cut-off of 0.80 as reference standard. The QFR-FFR hybrid approach was modeled using the intermediate zone of 0.77 to 0.87 assuming that lesions within the intermediate zone follow the FFR binary cutoff. Results In total, 381 vessels in 289 patients were analyzed. The sensitivity, specificity and accuracy on a per vessel-based analysis were 84.6%, 86.3% and 85.6% for QFR and 91.1%, 95.3% and 93.4% for the QFR-FFR hybrid approach. The diagnostic accuracy of QFR-FFR hybrid strategy with invasive FFR measurement is 93.4% and results in a FFR reduction of 56.7%. Conclusion QFR has a good correlation and agreement with invasive FFR and a high diagnostic accuracy. A hybrid QFR-FFR approach could extend the use of QFR and reduces the proportion of invasive FFR-measurements needed while maintaining a high accuracy. Hybrid QFR-FFR strategy Funding Acknowledgement Type of funding source: None

scholarly journals Diagnostic performance and clinical implications for enhancing a hybrid quantitative flow ratio–FFR revascularization decision-making strategy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Joyce Peper ◽  
Robbert W. van Hamersvelt ◽  
Benno J. W. M. Rensing ◽  
Jan-Peter van Kuijk ◽  
Michiel Voskuil ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Invasive Coronary Angiography ◽  
Hybrid Approach ◽  
Intermediate Zone ◽  
Flow Ratio ◽  
Fractional Flow ◽  
Hybrid Strategy ◽  
Flow Reserve ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

AbstractInvasive fractional flow reserve (FFR) adoption remains low mainly due to procedural and operator related factors as well as costs. Alternatively, quantitative flow ratio (QFR) achieves a high accuracy mainly outside the intermediate zone without the need for hyperaemia and wire-use. We aimed to determine the diagnostic performance of QFR and to evaluate a QFR–FFR hybrid strategy in which FFR is measured only in the intermediate zone. This retrospective study included 289 consecutive patients who underwent invasive coronary angiography and FFR. QFR was calculated for all vessels in which FFR was measured. The QFR–FFR hybrid approach was modelled using the intermediate zone of 0.77–0.87 in which FFR-measurements are recommended. The sensitivity, specificity, and accuracy on a per vessel-based analysis were 84.6%, 86.3% and 85.6% for QFR and 88.0%, 92.9% and 90.3% for the QFR–FFR hybrid approach. The diagnostic accuracy of QFR–FFR hybrid strategy with invasive FFR measurement was 93.4% and resulted in a 56.7% reduction in the need for FFR. QFR has a good correlation and agreement with invasive FFR. A hybrid QFR–FFR approach could extend the use of QFR and reduces the proportion of invasive FFR-measurements needed while improving accuracy.

scholarly journals Computational quantitative flow ratio to assess functional severity of coronary artery stenosis

2018 ◽  
Vol 271 ◽  
pp. 36-41 ◽  
Author(s):  
Daan Ties ◽  
Randy van Dijk ◽  
Gabija Pundziute ◽  
Erik Lipsic ◽  
Ton E. Vonck ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Flow Ratio ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Abstract 14743: Usefulness of Estimated Coronary Flow Velocity Using Quantitative Flow Ratio for Intermediate Coronary Stenosis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Eiji Ichimoto ◽  
Nao Konagai ◽  
Sawako Horie ◽  
Atsushi Hasegawa ◽  
Hirofumi Miyahara ◽  
...  
Keyword(s):  
Flow Velocity ◽  
Coronary Stenosis ◽  
Coronary Flow ◽  
Flow Ratio ◽  
Operating Characteristics ◽  
Fractional Flow ◽  
Coronary Flow Velocity ◽  
Flow Reserve ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Introduction: Quantitative flow ratio (QFR) is a diagnostic modality for functional assessment for intermediate coronary stenosis without the use of pressure wire. QFR is calculated from 3-dimensional quantitative CAG (3D-QCA) using an advanced algorithm that enables fast computation of the pressure drop caused by coronary stenosis. Hypothesis: We assessed the usefulness of QFR and the association with an estimated coronary flow velocity (eCFV) for intermediate coronary stenosis. Methods: A total of 100 lesions in 80 consecutive patients were assessed Fractional Flow Reserve (FFR) for intermediate coronary stenosis between January 2011 and April 2019. Of these, 97 lesions in 77 patients who underwent QFR were included in this study. Patients were classified into two groups (FFR ≤ 0.80 or FFR > 0.80). QFR and eCFV using contrast were measured by Thrombolysis in Myocardial Infarction (TIMI) frame counts. Results: There was no significant differences in target vessels (p = 0.90) and diffuse lesions (p = 0.06) between the two groups (FFR ≤ 0.80 or FFR > 0.80). Mean FFR and QFR values were 0.78 ± 0.12 and 0.77 ± 0.11, respectively. QFR had a good correlation with FFR values (r = 0.86, p < 0.0001). The diagnostic accuracy, sensitivity, and specificity on QFR ≤ 0.80 were 91.8%, 92.7% and 90.5%, respectively. The eCFV of FFR ≤ 0.80 was greater than that of FFR > 0.80 (0.19 ± 0.08 m/s vs. 0.14 ± 0.06 m/s, p<0.001). Figure showed that the eCFV correlated with FFR values (r = -0.29, p < 0.01). Moreover, the eCFV had a high area under the curve (AUC = 0.71, p < 0.01) on Receiver operating characteristics curve (ROC) analysis with FFR ≤ 0.80. Conclusions: QFR was useful for the assessment of functional stenosis severity. As eCFV was faster, FFR was lower for intermediate coronary stenosis. The eCFV had a good correlation with FFR and may become one of the evaluations for ischemia.

scholarly journals 300.14 Quantitative Flow Ratio (QFR) Inter− and Intra−Observer Reproducibility Assessed at Baseline and After 1 Week

2019 ◽  
Vol 12 (4) ◽  
pp. S32
Author(s):  
Alexandre Hideo-Kajita ◽  
Yuichi Ozaki ◽  
Cristiano Bezerra ◽  
Kazuhiro Dan ◽  
Gebremedhin D. Melaku ◽  
...  
Keyword(s):  
Flow Ratio ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

scholarly journals Sex Differences in the Non-infarct-Related Artery-Based Quantitative Flow Ratio in Patients With ST-Elevation Myocardial Infarction: A Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Hongli Hou ◽  
Qi Zhao ◽  
Chao Qu ◽  
Meng Sun ◽  
Qi Liu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Sex Differences ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Clinical Outcomes ◽  
Flow Ratio ◽  
Infarct Related Artery ◽  
St Elevation ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Introduction: It has been reported that sex has well-established relationships with the prevalence of coronary artery disease (CAD) and the major adverse cardiovascular events. Compared with men, the difference of coronary artery and myocardial characteristics in women has effects on anatomical and functional evaluations. Quantitative flow ratio (QFR) has been shown to be effective in assessing the hemodynamic relevance of lesions in stable coronary disease. However, its suitability in acute myocardial infarction patients is unknown. This study aimed to evaluate the sex differences in the non-infarct-related artery (NIRA)-based QFR in patients with ST-elevation myocardial infarction (STEMI).Methods: In this study, 353 patients with STEMI who underwent angiographic cQFR assessment and interventional therapy were included. According to contrast-flow QFR (cQFR) standard operating procedures: reliable software was used to modeling the hyperemic flow velocity derived from coronary angiography in the absence of pharmacologically induced hyperemia. 353 patients were divided into two groups according to sex. A cQFR ≤0.80 was considered hemodynamically significant, whereas invasive coronary angiography (ICA) luminal stenosis ≥50% was considered obstructive. Demographics, clinical data, NIRA-related anatomy, and functional cQFR values were recorded. Clinical outcomes included the NIRA reclassification rate between men and women, according to the ICA and cQFR assessments.Results: Women were older and had a higher body mass index (BMI) than men. The levels of diastolic blood pressure, troponin I, peak creatine kinase-MB, low-density lipoprotein cholesterol, N terminal pro B-type natriuretic peptide, stent diameter, and current smoking rate were found to be significantly lower in the female group than in the male group. Women had a lower likelihood of a positive cQFR ≤0.80 for the same degree of stenosis and a lower rate of NIRA revascularization. Independent predictors of positive cQFR included male sex and diameter stenosis (DS) &gt;70%.Conclusions: cQFR values differ between the sexes, as women have a higher cQFR value for the same degree of stenosis. The findings suggest that QFR variations by sex require specific interpretation, as these differences may affect therapeutic decision-making and clinical outcomes.

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