132 Diagnostic Accuracy of Stress Echocardiography Compared with Invasive Coronary Angiography with Fractional Flow Reserve for The Diagnosis of Haemodynamically Significant Cad in Patients with Known or Suspected CAD

Abstract Aims Quantitative flow ratio (QFR) is a recently developed technique to calculate fractional flow reserve (FFR) based on 3D quantitative coronary angiography and computational fluid dynamics, obviating the need for a pressure-wire and hyperaemia induction. QFR might be used to guide patient selection for FFR and subsequent percutaneous coronary intervention (PCI) referral in hospitals not capable to perform FFR and PCI. We aimed to investigate the feasibility to use QFR to appropriately select patients for FFR referral. Methods and results Patients who underwent invasive coronary angiography in a hospital where FFR and PCI could not be performed and were referred to our hospital for invasive FFR measurement, were included. Angiogram images from the referring hospitals were retrospectively collected for QFR analysis. Based on QFR cut-off values of 0.77 and 0.86, our patient cohort was reclassified to ‘no referral’ (QFR ≥0.86), referral for ‘FFR’ (QFR 0.78–0.85), or ‘direct PCI’ (QFR ≤0.77). In total, 290 patients were included. Overall accuracy of QFR to detect an invasive FFR of ≤0.80 was 86%. Based on a QFR cut-off value of 0.86, a 50% reduction in patient referral for FFR could be obtained, while only 5% of these patients had an invasive FFR of ≤0.80 (thus, these patients were incorrectly reclassified to the ‘no referral’ group). Furthermore, 22% of the patients that still need to be referred could undergo direct PCI, based on a QFR cut-off value of 0.77. Conclusion QFR is feasible to use for the selection of patients for FFR referral.

Download Full-text

TCT-175 Diagnostic performance of Fractional Flow Reserve derived from Computed Tomography compared to Invasive Coronary Angiography derived Fractional Flow Reserve

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2017.09.243 ◽

2017 ◽

Vol 70 (18) ◽

pp. B75

Author(s):

Jai Parekh ◽

Saurabh Aggarwal ◽

Rohit Loomba ◽

Gaurav Aggarwal ◽

Ram Belbase ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Angiography ◽

Fractional Flow Reserve ◽

Diagnostic Performance ◽

Invasive Coronary Angiography ◽

Fractional Flow ◽

Flow Reserve

Download Full-text

Significance of Microvascular Function in Visual—Functional Mismatch Between Invasive Coronary Angiography and Fractional Flow Reserve

Journal of the American Heart Association ◽

10.1161/jaha.117.005916 ◽

2017 ◽

Vol 6 (6) ◽

Cited By ~ 10

Author(s):

Taishi Yonetsu ◽

Tadashi Murai ◽

Yoshihisa Kanaji ◽

Tetsumin Lee ◽

Junji Matsuda ◽

...

Keyword(s):

Coronary Angiography ◽

Fractional Flow Reserve ◽

Invasive Coronary Angiography ◽

Microvascular Function ◽

Fractional Flow ◽

Flow Reserve

Download Full-text

Lesion Length Improves Diagnostic Accuracy of Intravascular Ultrasound for Detecting Functional Intermediate Coronary Stenosis Evaluated With Coronary Angiography-Derived Fractional Flow Reserve in Non-left Main Artery

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.715514 ◽

2021 ◽

Vol 8 ◽

Author(s):

Menghuan Li ◽

Iokfai Cheang ◽

Yuan He ◽

Shengen Liao ◽

Hui Wang ◽

...

Keyword(s):

Coronary Angiography ◽

Diagnostic Accuracy ◽

Intravascular Ultrasound ◽

Fractional Flow Reserve ◽

Coronary Stenosis ◽

Lesion Length ◽

Left Main ◽

Fractional Flow ◽

Main Artery ◽

Flow Reserve

Objective: Intravascular ultrasound (IVUS) parameters, for example, minimal lumen area (MLA) and area stenosis (AS), poorly identified functional intermediate coronary stenosis (ICS). For detecting functional ICS defined by coronary angiography-derived fractional flow reserve (caFFR), our study aims to determine whether IVUS parameters integrated with lesion length (LL) by three-dimensional quantitative coronary analysis (3D-QCA) could improve diagnostic value.Methods: A total of 111 patients with 122 ICS lesions in the non-left main artery were enrolled. MLA and AS were calculated in all lesions by IVUS. Diameter stenosis (DS%) and LL were measured by 3D-QCA. caFFR was computed by the proprietary fluid dynamic algorithm, a caFFR ≤ 0.8 was considered as functional stenosis. Receiver-operating curve analyses were used to compare the diagnostic accuracy among indices to predict functional stenoses.Results: Mean caFFR values in all lesions were 0.86 ± 0.09. Lesions with caFFR ≤ 0.8 showed lower MLA and higher AS (MLA: 3.3 ± 0.8 vs. 4.1 ± 1.2, P = 0.002; AS: 71.3 ± 9.6% vs. 63.5 ± 1.3%, P = 0.007). DS% and LL were more severe in lesions with caFFR ≤ 0.8 (DS%: 45.5 ± 9.6% vs. 35.5 ± 8.2%, P < 0.001; LL: 31.6 ± 12.9 vs. 21.0 ± 12.8, P < 0.001). caFFR were correlated with MLA, AS, and LL (MLA: r = 0.36, P < 0.001; AS: r = −0.36, P < 0.001; LL: r = −0.41, P < 0.001). Moreover, a multiple linear regression analysis demonstrated that MLA (β = 0.218, P = 0.013), AS (β = −0.197, P = 0.029), and LL (β = −0.306, P > 0.001) contributed significantly to the variation in caFFR. The best cutoff value of MLA, AS, and LL for predicting caFFR ≤ 0.8 were 3.6 mm2, 73%, and 26 mm, with area under the curve (AUC) of 0.714, 0.688, and 0.767, respectively. Combined with MLA, AS, and LL for identifying functional ICS, the accuracy was the highest among study methods (AUC: 0.845, P < 0.001), and was significantly higher than each single method (All P < 0.05).Conclusion: Lesion length can improve the diagnostic accuracy of IVUS-derived parameters for detecting functional ICS.

Download Full-text