scholarly journals Meta-Analysis of Diagnostic Performance of Contrast-Fractional Flow Reserve versus Quantitative Flow Ratio for Functional Assessment of Coronary Stenoses

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Ruitao Zhang ◽  
Jianwei Zhang ◽  
Lijun Guo
Keyword(s):  
Sensitivity And Specificity ◽  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Flow Ratio ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Background. Use of the fractional flow reserve (FFR) technique is recommended to evaluate coronary stenosis severity and guide revascularization. However, its high cost, time to administer, and the side effects of adenosine reduce its clinical utility. Two novel adenosine-free indices, contrast-FFR (cFFR) and quantitative flow ratio (QFR), can simplify the functional evaluation of coronary stenosis. This study aimed to analyze the diagnostic performance of cFFR and QFR using FFR as a reference index. Methods. We conducted a systematic review and meta-analysis of observational studies in which cFFR or QFR was compared to FFR. A bivariate model was applied to pool diagnostic parameters. Cochran’s Q test and the I2 index were used to assess heterogeneity and identify the potential source of heterogeneity by metaregression and sensitivity analysis. Results. Overall, 2220 and 3000 coronary lesions from 20 studies were evaluated by cFFR and QFR, respectively. The pooled sensitivity and specificity were 0.87 (95% CI: 0.81, 0.91) and 0.92 (95% CI: 0.88, 0.94) for cFFR and 0.87 (95% CI: 0.82, 0.91) and 0.91 (95% CI: 0.87, 0.93) for QFR, respectively. No statistical significance of sensitivity and specificity for cFFR and QFR were observed in the bivariate analysis (P=0.8406 and 0.4397, resp.). The area under summary receiver-operating curve of cFFR and QFR was 0.95 (95% CI: 0.93, 0.97) for cFFR and 0.95 (95% CI: 0.93, 0.97). Conclusion. Both cFFR and QFR have good diagnostic performance in detecting functional severity of coronary arteries and showed similar diagnostic parameters.

scholarly journals Meta-Analysis of Diagnostic Performance of Instantaneous Wave-Free Ratio versus Quantitative Flow Ratio for Detecting the Functional Significance of Coronary Stenosis

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Wenjie Zuo ◽  
Mingming Yang ◽  
Yifan Chen ◽  
Aiming Xie ◽  
Lijuan Chen ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Coronary Stenosis ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Receiver Operating Curve ◽  
Flow Ratio ◽  
Fractional Flow ◽  
Coronary Lesions ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Background. Fractional flow reserve (FFR), as a functional measurement of coronary stenosis, is recommended for guiding revascularization in intermediate coronary lesions. However, it still remains underutilized for potential reasons including time consumption, costs, or contraindications associated with adenosine administration. Here we performed this meta-analysis to assess the diagnostic performance of two adenosine-free indices, instantaneous wave free-ratio (iFR), and quantitative flow ratio (QFR) in evaluating coronary stenosis severity with FFR as the reference standard. Methods. PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched to include relevant studies with the diagnostic accuracy of iFR or QFR referenced to FFR. A bivariate model was applied to pool diagnostic parameters. We used Cochran’s Q test and I2 index to assess heterogeneity and identify the potential source of heterogeneity by meta-regression. Results. A total of 8213 lesions from 28 studies (19 for iFR and 9 for QFR) were included in this meta-analysis. The pooled sensitivity and specificity were 0.79 (95% CI, 0.75 to 0.83) and 0.85 (95% CI, 0.82 to 0.87) for iFR and 0.90 (95% CI, 0.84 to 0.93) and 0.88 (95% CI, 0.86 to 0.90) for QFR, respectively. Significantly higher sensitivity and specificity were observed in the bivariate analysis for QFR than for iFR (P < 0.001 for both). The area under summary receiver-operating curve of iFR and QFR was 0.89 (95% CI, 0.86 to 0.92) and 0.92 (95% CI, 0.89 to 0.94). Conclusion. Evidence suggests that both of the two indices have good performance in detecting functional ischemia of coronary arteries and QFR might be a promising method without requiring the pressure wire. Further application of QFR may potentially provide important information to clinicians in the assessment of coronary lesions.

scholarly journals Is quantitative flow ratio enough to accurately assess intermediate coronary stenosis? A comparison study with fractional flow reserve

2020 ◽  
Vol 26 (6) ◽  
pp. 793-795
Author(s):  
Paweł Kleczyński ◽  
Artur Dziewierz ◽  
Lukasz Rzeszutko ◽  
Dariusz Dudek ◽  
Jacek Legutko
Keyword(s):  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Comparison Study ◽  
Flow Ratio ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Diagnostic Agreement of Quantitative Flow Ratio with Fractional Flow Reserve in a Latin-American Population

2021 ◽  
Author(s):  
Mauro Echavarria Pinto ◽  
Tim P. Van de Hoef ◽  
Nancy Pacheco-Beltran ◽  
Jesus Eduardo Reyes-Carrera ◽  
Eduardo Rangel-Alvarado ◽  
...  
Keyword(s):  
Latin American ◽  
Fractional Flow Reserve ◽  
Diagnostic Performance ◽  
American Population ◽  
Flow Ratio ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow ◽  
Latin American Population

Abstract Purpose: Quantitative flow ratio (QFR) is a recently proposed angiographic index that allows to assess the pressure loss in coronary arteries in a similar fashion as the accepted standard fractional flow reserve (FFR). The purpose of this study was to evaluate the diagnostic performance of QFR as compared to FFR, in a Latin-American population of patients with suspected ischaemic heart disease.Methods: QFR was retrospectively derived from coronary angiograms. The association, diagnostic performance, and continuous agreement of fixed-flow QFR (fQFR) and contrast-flow QFR (cQFR) with FFR was assessed by continuous and dichotomous methods.Results: 90 vessels form 63 patients were finally included. The study comprised coronary stenoses of intermediate severity, both angiographically (diameter stenosis: 46.6 ± 12.8%) and physiologically [median FFR=0.86 (quartile 1-3, 0.76-0.89)]. The correlation of FFR with both fQFR [ρ=0.841, (95% CI: 0.767 to 0.893), p<0.001] and cQFR [ρ=0.833, (95% CI: 0.755 to 0.887), p<0.001] was strong. The diagnostic performance of cQFR was numerically better [area under the ROC curve of 0.92 (95% CI: 0.86 to 0.97, p<0.001)], with 0.80 as the optimal cQFR cut-off against FFR≤0.80. This 0.80 cQFR cut-off classified correctly 83.3% of total stenoses, with a sensitivity of 85.2% and specificity of 80.6%.Conclusions: QFR was strongly associated with FFR and exhibited a high diagnostic performance in this Latin-American population.

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