scholarly journals CORRIGENDUM: Diagnostic Performance and Pressure Stability of a Novel Myocardial Ischemic Diagnostic Index　― The Intracoronary-Electrocardiogram-Triggered Distal Pressure/Aortic Pressure Ratio ―

2021 ◽  
Vol 3 (6) ◽  
pp. 360
Author(s):  
Masafumi Nakayama ◽  
Takashi Uchiyama ◽  
Nobuhiro Tanaka ◽  
Takaaki Ohkawauchi ◽  
Shunsuke Miwa ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Pressure Ratio ◽  
Aortic Pressure ◽  
Pressure Stability ◽  
Diagnostic Index

Abstract 17034: Diagnostic Accuracy of Diastolic Pressure Ratio Using a Microcatheter: An Analysis of the ACIST-FFR Study

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Matthew Price ◽  
Jaden Yang ◽  
Jeffrey Chambers ◽  
Arnold Seto ◽  
Iam Sarembock ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diastolic Pressure ◽  
Pressure Ratio ◽  
Aortic Pressure ◽  
Paired Data ◽  
System A ◽  
Pressure Wire ◽  
Stable Cad ◽  
Highly Correlated ◽  
Automated Software

Background: The diastolic pressure ratio (dPR) is a non-hyperemic index used to measure the ratio of distal coronary to aortic pressure during a diastolic portion of the cardiac cycle. dPR indices measured by a pressure wire have similar diagnostic accuracy as iFR for FFR. The accuracy of dPR using a microcatheter (MC) has not been defined. Methods: The ACIST-FFR study was a prospective, multicenter study of a pressure-monitoring MC in patients with stable CAD. Using an automated software algorithm, dPR with the MC was defined as the Pd/Pa at the location within the diastolic period that was 50% of the distance from the peak of one waveform to the peak of the next waveform, averaged over a 5-beat period. iFR with the MC was computed in the usual fashion by the core laboratory from the original pressure tracings. Results: A total of 161 paired data samples from 11 sites were analyzed. dPR was highly correlated with iFR (R 2 =0.992, AUC=0.998 with a mean bias of -0.0237 (95% CI, -0.0041 to -0.0011) and provided a sensitivity of 98%, specificity 96%, and diagnostic accuracy of 96.9%. The optimal cutpoint of dPR for FFR was 0.91 (AUC=0.886), which provided a sensitivity of 82%, specificity of 80%, and diagnostic accuracy of 81%. The diagnostic accuracy of iFR for FFR was 81%, with a sensitivity of 82%, and specificity 80%. Conclusions: With a MC system, a non-hyperemic diastolic pressure ratio is highly correlated with iFR, and provides similar diagnostic accuracy as iFR for FFR.

Combining Baseline Distal-to-Aortic Pressure Ratio and Fractional Flow Reserve in the Assessment of Coronary Stenosis Severity

2015 ◽  
Vol 8 (13) ◽  
pp. 1681-1691 ◽  
Author(s):  
Mauro Echavarría-Pinto ◽  
Tim P. van de Hoef ◽  
Martijn A. van Lavieren ◽  
Sukhjinder Nijjer ◽  
Borja Ibañez ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Pressure Ratio ◽  
Aortic Pressure ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Stenosis Severity

scholarly journals TCT-300 Combining baseline distal-to-aortic pressure ratio and fractional flow reserve in the assessment of coronary stenosis severity

2015 ◽  
Vol 66 (15) ◽  
pp. B119
Author(s):  
Mauro Echavarria-Pinto ◽  
Tim P. van de Hoef ◽  
Martijn A. van Lavieren ◽  
Sukhjinder S. Nijjer ◽  
Borja Ibañez ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Pressure Ratio ◽  
Aortic Pressure ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Stenosis Severity

scholarly journals Temporal dissociation between the minimal distal-to-aortic pressure ratio and peak hyperemia during intravenous adenosine infusion

2017 ◽  
Vol 312 (5) ◽  
pp. H992-H1001 ◽  
Author(s):  
Lorena Casadonte ◽  
Koen M. Marques ◽  
Jos A. E. Spaan ◽  
Maria Siebes
Keyword(s):  
Flow Velocity ◽  
Coronary Flow ◽  
Fluid Dynamic ◽  
Pressure Ratio ◽  
Aortic Pressure ◽  
Adenosine Infusion ◽  
Maximal Velocity ◽  
Systemic Hemodynamic ◽  
Stenosis Severity ◽  
Adenosine Administration

The present study sought to compare the temporal relation between maximal coronary flow (peak hyperemia) and minimal coronary-to-aortic pressure ratio (Pd/Pa) for intracoronary (IC) and intravenous (IV) adenosine administration. Peak hyperemia is assumed to coincide with the minimal Pd/Pa value. However, this has not been confirmed for systemic hemodynamic variations during IV adenosine infusion. Hemodynamic responses to IV and IC adenosine administration were obtained in 12 patients (14 lesions) using combined IC pressure and flow velocity measurements. A fluid dynamic model was used to predict the change in Pd/Pa for different stenosis severities and varying Pa. Hemodynamic variability during IV adenosine hyperemia was greater than during IC adenosine, as assessed by the coefficient of variation. During IV adenosine, flow velocity peaked 28 ± 4 (SE) s after the onset of hyperemia, while Pd/Pa reached a minimum (0.82 ± 0.01) 22 ± 7 s later ( P < 0.05), when Pa had declined by 6.1% and hyperemic velocity by 4.5% ( P < 0.01). Model outcomes corroborated the role of variable Pa in this dissociation. In contrast, maximal flow and minimal Pd/Pa coincided for IC adenosine, with IV-equivalent peak velocities and a higher Pd/Pa ratio (0.86 ± 0.01, P < 0.01). Hemodynamic variability during continuous IV adenosine infusion can lead to temporal dissociation of minimal Pd/Pa and peak hyperemia, in contrast to IC adenosine injection, where maximal velocity and minimal Pd/Pa coincide. Despite this variability, stenosis hemodynamics remained stable with both ways of adenosine administration. Our findings suggest advantages of IC over IV adenosine to identify maximal hyperemia from pressure-only measurements. NEW & NOTEWORTHY Systemic hemodynamic variability during intravenous adenosine infusion produces substantial temporal dissociation between peak hyperemia appraised by coronary flow velocity and the minimal distal-to-aortic pressure ratio commonly used to determine functional stenosis severity. This dissociation was absent for intracoronary adenosine administration and tended to be mitigated in patients receiving Ca2+ antagonists.

scholarly journals Diagnostic Accuracy of Baseline Distal-to-Aortic Pressure Ratio to Assess Coronary Stenosis Severity

2015 ◽  
Vol 8 (6) ◽  
pp. 834-836 ◽  
Author(s):  
Mauro Echavarría-Pinto ◽  
Tim P. van de Hoef ◽  
Hector M. Garcia-Garcia ◽  
Ton de Vries ◽  
Patrick W. Serruys ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Coronary Stenosis ◽  
Pressure Ratio ◽  
Aortic Pressure ◽  
Stenosis Severity
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