scholarly journals Non-randomized comparison between revascularization and deferral for intermediate coronary stenosis with abnormal fractional flow reserve and preserved coronary flow reserve

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Doosup Shin ◽  
Joo Myung Lee ◽  
Seung Hun Lee ◽  
Doyeon Hwang ◽  
Ki Hong Choi ◽  
...  
Keyword(s):  
Coronary Flow Reserve ◽  
Fractional Flow Reserve ◽  
International Collaboration ◽  
Coronary Stenosis ◽  
Coronary Flow ◽  
Target Vessel ◽  
Fractional Flow ◽  
Patient Level ◽  
Flow Reserve ◽  
Significant Difference

AbstractLimited data are available regarding comparative prognosis after percutaneous coronary intervention (PCI) versus deferral of revascularization in patients with intermediate stenosis with abnormal fractional flow reserve (FFR) but preserved coronary flow reserve (CFR). From the International Collaboration of Comprehensive Physiologic Assessment Registry (NCT03690713), a total of 330 patients (338 vessels) who had coronary stenosis with FFR ≤ 0.80 but CFR > 2.0 were selected for the current analysis. Patient-level clinical outcome was assessed by major adverse cardiac events (MACE) at 5 years, a composite of all-cause death, target-vessel myocardial infarction (MI), or target-vessel revascularization. Among the study population, 231 patients (233 vessels) underwent PCI and 99 patients (105 vessels) were deferred. During 5 years of follow-up, cumulative incidence of MACE was 13.0% (31 patients) without significant difference between PCI and deferred groups (12.7% vs. 14.0%, adjusted HR 1.301, 95% CI 0.611–2.769, P = 0.495). Multiple sensitivity analyses by propensity score matching and inverse probability weighting also showed no significant difference in patient-level MACE and vessel-specific MI or revascularization. In this hypothesis-generating study, there was no significant difference in clinical outcomes between PCI and deferred groups among patients with intermediate stenosis with FFR ≤ 0.80 but CFR > 2.0. Further study is needed to confirm this finding.Clinical Trial Registration: International Collaboration of Comprehensive Physiologic Assessment Registry (NCT03690713; registration date: 10/01/2018).

Diagnostic cutoff for pressure drop coefficient in relation to fractional flow reserve and coronary flow reserve: A Patient-Level Analysis

2015 ◽  
Vol 87 (2) ◽  
pp. 273-282 ◽  
Author(s):  
Kranthi K. Kolli ◽  
Tim P. van de Hoef ◽  
Mohamed A. Effat ◽  
Rupak K. Banerjee ◽  
Srikara V. Peelukhana ◽  
...  
Keyword(s):  
Pressure Drop ◽  
Coronary Flow Reserve ◽  
Fractional Flow Reserve ◽  
Coronary Flow ◽  
Fractional Flow ◽  
Patient Level ◽  
Flow Reserve ◽  
Level Analysis

scholarly journals Discordance Between Fractional Flow Reserve and Coronary Flow Reserve

2017 ◽  
Vol 10 (10) ◽  
pp. 999-1007 ◽  
Author(s):  
Sung Gyun Ahn ◽  
Jon Suh ◽  
Olivia Y. Hung ◽  
Hee Su Lee ◽  
Yasir H. Bouchi ◽  
...  
Keyword(s):  
Coronary Flow Reserve ◽  
Fractional Flow Reserve ◽  
Coronary Flow ◽  
Fractional Flow ◽  
Flow Reserve

Optimal Dosage and Method of Administration of Adenosine for Measuring the Coronary Flow Reserve and the Fractional Flow Reserve in Koreans

2006 ◽  
Vol 36 (4) ◽  
pp. 300 ◽  
Author(s):  
Jung Won Suh ◽  
Bon Kwon Koo ◽  
Sang Ho Jo ◽  
Hyun Jae Kang ◽  
Young Seok Cho ◽  
...  
Keyword(s):  
Coronary Flow Reserve ◽  
Fractional Flow Reserve ◽  
Coronary Flow ◽  
Optimal Dosage ◽  
Fractional Flow ◽  
Flow Reserve

scholarly journals Fractional Flow Reserve or Coronary Flow Reserve for the Assessment of Myocardial Perfusion

2018 ◽  
Vol 20 (9) ◽  
Author(s):  
Valérie E. Stegehuis ◽  
Gilbert W. Wijntjens ◽  
Jan J. Piek ◽  
Tim P. van de Hoef
Keyword(s):  
Myocardial Perfusion ◽  
Coronary Flow Reserve ◽  
Fractional Flow Reserve ◽  
Coronary Flow ◽  
Fractional Flow ◽  
Flow Reserve

scholarly journals A validated predictive model of coronary fractional flow reserve

2011 ◽  
Vol 9 (71) ◽  
pp. 1325-1338 ◽  
Author(s):  
Yunlong Huo ◽  
Mark Svendsen ◽  
Jenny Susana Choy ◽  
Z.-D. Zhang ◽  
Ghassan S. Kassab
Keyword(s):  
Analytical Model ◽  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Coronary Flow ◽  
Energy Losses ◽  
Fractional Flow ◽  
Conservation Of Energy ◽  
Flow Reserve

Myocardial fractional flow reserve (FFR), an important index of coronary stenosis, is measured by a pressure sensor guidewire. The determination of FFR, only based on the dimensions (lumen diameters and length) of stenosis and hyperaemic coronary flow with no other ad hoc parameters, is currently not possible. We propose an analytical model derived from conservation of energy, which considers various energy losses along the length of a stenosis, i.e. convective and diffusive energy losses as well as energy loss due to sudden constriction and expansion in lumen area. In vitro (constrictions were created in isolated arteries using symmetric and asymmetric tubes as well as an inflatable occluder cuff) and in vivo (constrictions were induced in coronary arteries of eight swine by an occluder cuff) experiments were used to validate the proposed analytical model. The proposed model agreed well with the experimental measurements. A least-squares fit showed a linear relation as (Δ p or FFR) experiment = a (Δ p or FFR) theory + b , where a and b were 1.08 and −1.15 mmHg ( r 2 = 0.99) for in vitro Δ p , 0.96 and 1.79 mmHg ( r 2 = 0.75) for in vivo Δ p , and 0.85 and 0.1 ( r 2 = 0.7) for FFR. Flow pulsatility and stenosis shape (e.g. eccentricity, exit angle divergence, etc.) had a negligible effect on myocardial FFR, while the entrance effect in a coronary stenosis was found to contribute significantly to the pressure drop. We present a physics-based experimentally validated analytical model of coronary stenosis, which allows prediction of FFR based on stenosis dimensions and hyperaemic coronary flow with no empirical parameters.

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