scholarly journals Diagnostic Performance of Immediate Angiography Derived Quantitative Flow Ratio In Patients After Second Generation Drug Eluting Stent And Bioresorable Scaffold Implantation

2021 ◽  
Keyword(s):  
Full Text ◽  
Diagnostic Performance ◽  
Second Generation ◽  
Drug Eluting Stent ◽  
Flow Ratio ◽  
Drug Eluting ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Abstract The full text of this preprint has been withdrawn by the authors due to author disagreement with the posting of the preprint. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.

Relationship of quantitative flow ratio after second-generation drug-eluting stent implantation to clinical outcomes

2019 ◽  
Vol 35 (6) ◽  
pp. 743-749 ◽  
Author(s):  
Nobuaki Suzuki ◽  
Seiji Nishide ◽  
Takahiro Kimura ◽  
Takashi Aoyagi ◽  
Kenta Kanamori ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Stent Implantation ◽  
Second Generation ◽  
Drug Eluting Stent ◽  
Flow Ratio ◽  
Drug Eluting ◽  
Quantitative Flow Ratio ◽  
Relationship Of ◽  
Quantitative Flow

scholarly journals Diagnostic Performance of Immediate Angiography Derived Quantitative Flow Ratio In Patients After Second Generation Drug Eluting Stent And Bioresorable Scaffold Implantation

2021 ◽  
Author(s):  
Zhengwei Li ◽  
Jiachen Zhan ◽  
Jia Han ◽  
Guosheng Fu ◽  
Chongying Jin
Keyword(s):  
Stent Implantation ◽  
Diagnostic Performance ◽  
Artery Bypass ◽  
Drug Eluting Stent ◽  
Flow Ratio ◽  
Fractional Flow ◽  
Coronary Syndrome ◽  
Flow Reserve ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Abstract Quantitative flow ratio (QFR) is a novel angiography derived fractional flow reserve (FFR). However, its diagnostic performance has only be validated in native coronary lesion but not yet in vessels after stent implantation. This study aims to evaluate the diagnostic performance of QFR in coronary vessels immediately after everolimus eluting stent (EES) and bioresorbable scaffold (BRS) implantation. This is a retrospective, two centers, validation cohort study. 73 stable angina patients who received at least one native vessel EES/BRS implantation with immediate FFR assessment were screened. Cases with aorta-ostial stenoses, bridge vessel at the distal of targated vessel, acute coronary syndrome, previous coronary artery bypass grafting, age < 18 years, lack of ≥ 2 final angiographic projections were excluded. Contrast QFR assessment was performed blinded to FFR assessment. A good correlation (r = 0.680, p < 0.001) was found between QFR and FFR. In the EES implantation cohort, a good correlation (r = 0.769, p < 0.001) was found between QFR and FFR, while moderate correlation (r = 0.446, p = 0.038) was found in the BRS cohort. The area under the ROC curve for detecting FFR ≤ 0.86 was 0.883 for the total subjects. QFR assessment after immediate EES/BRS implantation is feasible, and remains good correlation and agreement with FFR. QFR might be a promising tool for guiding stent implantation optimizing to improve clinical outcomes.

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 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.

1268A comparison between the diagnostic performance of quantitative flow ratio and non-invasive imaging modalities for diagnosing myocardial ischemia defined by FFR, a PACIFIC-trial interim analysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P A A Van Diemen ◽  
R S Driessen ◽  
R A Kooistra ◽  
W J Stuijfzand ◽  
P G Raijmakers ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Myocardial Ischemia ◽  
Positive Predictive Value ◽  
Flow Velocity ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Emission Tomography ◽  
Flow Ratio ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Abstract Background Quantitative flow ratio (QFR) uses fast computational algorithms based on 3-dimensional quantitative coronary angiography and estimation of contrast flow velocity during invasive coronary angiography (ICA) to obtain QFR values equivalent to fractional flow reserve (FFR). Objective To compare the diagnostic performance of QFR with coronary computed tomography angiography (CCTA), single-photon emission tomography (SPECT), and positron emission tomography (PET) for diagnosing myocardial ischemia defined by FFR. Method QFR computation was attempted in 109 patients (286 vessels without a subtotal/total lesion) of the 208 patients included in the PACIFIC-trial. Patients underwent 256-slice CCTA, Tetrofosmin SPECT, and [15O]H2O PET prior to ICA in conjunction with 3 vessel FFR measurements. ICA images were obtained without the use of a dedicated QFR acquistion protocol. QFR was calculated using a fixed empiric hyperemic flow velocity (fQFR) as well as using a patient specific flow velocity based on contrast passage through the coronary (cQFR). All analysis were performed on a per vessel level. Results Fixed QFR computation succeeded in 152 (53%) vessels while cQFR analysis was successful in 140 (49%) vessels. A good correlation between FFR and fQFR/cQFR was observed (R=0.774, p<0.001/R=0.790, p<0.001). The diagnostic performance in terms of sensitivity, specificity, negative predictive value, positive predictive value, and accuracy is presented in table 1. In total, 133 vessels with matched FFR, fQFR, cQFR, CCTA, SPECT, and PET results were available for the comparative C-statistic analysis, figure 1. The diagnostic performance of fQFR and cQFR was comparable (p=0.451) and superior to CCTA (p=0.004/p=0.003), SPECT (p<0.001/p<0.001), and PET (p=0.008/p=0.006), figure 1. CCTA, and PET performed alike (p=0.568) and outperformed SPECT (p=0.023, p=0.002). Table 1 % (95% Confidence Interval) fQFR n=152 cQFR (n=140) CCTA (n=152) SPECT (n=150) PET (n=149) Sensitivity 76 (59–89) 71 (53–86) 70 (51–84) 30 (16–49) 76 (58–89) Specificity 94 (88–98) 93 (86–97) 73 (64–81) 96 (90–99) 80 (72–87) Negative Predictive Value 93 (88–96) 92 (86–95) 90 (84–94) 83 (79–86) 92 (86–96) Positive Predictive Value 79 (64–89) 74 (59–85) 42 (33–51) 67 (42–84) 52 (42–62) Accuracy 90 (84–94) 88 (81–93) 72 (65–79) 81 (74–87) 79 (72–85) Figure 1. Conclusion Fixed QFR and cQFR correlate well with FFR with a high diagnostic accuracy as result. QFR outperformed CCTA, SPECT, and PET for the diagnosis of myocardial ischemia on a per vessel basis with the important footnote that fQFR and cQFR could only be computed in 53%, and 49% of the vessels.

Sign in / Sign up

Export Citation Format

Share Document