scholarly journals Relationship Between Immunoinflammation and Coronary Physiology Evaluated by Quantitative Flow Ratio in Patients With Coronary Artery Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Chengzhe Liu ◽  
Zhiyao Yu ◽  
Huaqiang Chen ◽  
Jun Wang ◽  
Wei Liu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
T Lymphocyte ◽  
Coronary Arteriography ◽  
Target Vessel ◽  
Flow Ratio ◽  
Coronary Physiology ◽  
Tnf Α ◽  
Artery Disease ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Background: The association between coronary physiology and immunoinflammation has not been investigated. We performed a retrospective study using quantitative flow ratio (QFR) to evaluate the interaction between immunoinflammatory biomarkers and coronary physiology.Methods: A total of 172 patients with CAD who underwent coronary arteriography (CAG) and QFR were continuously enrolled from May 2020 to February 2021. As a quantitative indicator of coronary physiology, QFR can reflect the functional severity of coronary artery stenosis. The target vessel measured by QFR was defined as that with the most severe lesions. Significant coronary anatomical stenosis was defined as 70% stenosis in the target vessel.Results: Compared with the QFR > 0.8 group, interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ were increased and CD3+ and CD4+ T lymphocyte counts were decreased in the QFR ≤ 0.8 group. In addition, patients with DS ≤ 70% had higher IL-6, IL-10, and TNF-α levels and decreased CD3+ and CD4+ T lymphocyte counts than those with DS > 70%. Logistic regression analysis indicated IL-6 to be an independent predictor of significant coronary functional and anatomic stenosis (odds ratio, 1.125; 95% CI, 1.059–1.196; P < 0.001). Receiver operating characteristic (ROC) analyses showed that IL-6 > 6.36 was predictive of QFR ≤ 0.8 of the target vessel. The combination of IL-6, IL-10 and CD4 improved the value for predicting QFR ≤ 0.8 of the target vessel (AUC, 0.737; 95% CI, 0.661–0.810).Conclusion: Among immunoinflammatory biomarkers, IL-6 was independently associated with a higher risk of QFR ≤ 0.8 of the target vessel. The combination of immunoinflammatory biomarkers was highly predictive of significant coronary functional and anatomic stenosis.

scholarly journals Impact of Arterial Remodeling of Intermediate Coronary Lesions on Long-Term Clinical Outcomes in Patients with Stable Coronary Artery Disease: An Intravascular Ultrasound Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Liang Geng ◽  
Peizhao Du ◽  
Yuan Yuan ◽  
Liming Gao ◽  
Yunkai Wang ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Intravascular Ultrasound ◽  
Clinical Event ◽  
Arterial Remodeling ◽  
Target Vessel ◽  
Flow Ratio ◽  
Coronary Lesions ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Background. Treatment of coronary intermediate lesions remains a controversy, and the role of arterial remodeling patterns determined by intravascular ultrasound in intermediate lesion is still not well known. The aim of this study was to investigate the impact of arterial remodeling of intermediate coronary lesions on long-term clinical outcomes. Methods. Arterial remodeling patterns were assessed in 212 deferred intermediate lesions from 162 patients after IVUS examination. Negative, intermediate, and positive remodeling was defined as a remodeling index of <0.88, 0.88∼1.0, and >1.0, respectively. The primary endpoint was the composite vessel-oriented clinical events, defined as the composition of target vessel-related cardiac death, target vessel-related myocardial infarction, and target vessel revascularization. Quantitative flow ratio was assessed for evaluating the functional significance of intermediate lesions. Results. 72 intermediate remodeling lesions were present in 66 patients, whereas 77 negative remodeling lesions were present in 71 patients, and 63 positive remodeling lesions were present in 55 patients. Negative remodeling lesions had the smallest minimum lumen area (4.16 ± 1.03 mm2 vs. 5.05 ± 1.39 mm2 vs. 4.85 ± 1.76 mm2; P < 0.01 ), smallest plaque burden (63.45 ± 6.13% vs. 66.12 ± 6.82% vs. 71.17 ± 6.45%; P < 0.01 ), and highest area stenosis rate (59.32% ± 10.15% vs. 54.61% ± 9.09% vs. 51.67% ± 12.96%; P < 0.01 ). No significant difference was found in terms of quantitative flow ratio among three groups. At 5 years follow-up, negative remodeling lesions had a higher rate of composite vessel-oriented clinical event (14.3%), compared to intermediate (1.4%, P = 0.004 ) or positive remodeling lesions (4.8%, P = 0.06 ). After adjusting for multiple covariates, negative remodeling remained an independent determinant for vessel-oriented clinical event (HR: 4.849, 95% CI 1.542–15.251, P = 0.007 ). Conclusion. IVUS-derived negative remodeling is associated with adverse long-term clinical outcome in stable patients with intermediate coronary artery stenosis.

Angiography-based quantitative flow ratio versus fractional flow reserve in patients with coronary artery disease and severe aortic stenosis

2020 ◽  
Vol 16 (4) ◽  
pp. e285-e292 ◽  
Author(s):  
Hernán Mejía-Rentería ◽  
Luis Nombela-Franco ◽  
Jean-Michel Paradis ◽  
Mattia Lunardi ◽  
Joo Myung Lee ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Severe Aortic Stenosis ◽  
Flow Ratio ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Artery Disease ◽  
Quantitative Flow Ratio ◽  
Ratio Versus ◽  
Quantitative Flow

scholarly journals Novel Insights Into the Interaction Between the Autonomic Nervous System and Inflammation on Coronary Physiology: A Quantitative Flow Ratio Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Jun Wang ◽  
Wei Liu ◽  
Huaqiang Chen ◽  
Chengzhe Liu ◽  
Meng Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nervous System ◽  
Coronary Artery ◽  
Target Vessel ◽  
Flow Ratio ◽  
Atherosclerotic Burden ◽  
Hs Crp ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow ◽  
New Onset

Background: Heart rate variability (HRV) was proposed as a noninvasive biomarker to stratify the risk of cardiovascular disease. However, it remains to be determined if HRV can be used as a surrogate for coronary artery physiology as analyzed by quantitative flow ratio (QFR) in patients with new-onset unstable angina pectoris (UAP).Methods: A total of 129 consecutive patients with new-onset UAP who underwent 24-h long-range 12-channel electrocardiography from June 2020 to December 2020 were included in this study. HRV, coronary angiography, and QFR information was retrieved from patient medical records, the severity of coronary lesions was evaluated using the Gensini score (GS), and total atherosclerotic burden was assessed using the three-vessel contrast QFR (3V-cQFR) calculated as the sum of cQFR in three vessels.Results: Multivariate logistic analysis showed that low-frequency power (LF) and high-sensitivity C-reactive protein (hs-CRP) were directly correlated with functional ischemia of target vessel, which were inversely correlated with total atherosclerotic burden as assessed by 3V-cQFR. Moreover, incorporation of the increase in LF into the existing model that uses clinical risk factors, GS, and hs-CRP significantly increased the discriminatory ability for evaluating coronary artery physiology of target vessel.Conclusions: LF and hs-CRP are independently associated with functional ischemia in patients with new-onset UAP. The relative increase of LF and hs-CRP could add value to the use of classical cardiovascular risk factors to predict the functional severity of coronary artery stenosis. Our results suggest a potential association between the autonomic nervous system, inflammation, and coronary artery physiology.

OP608 The Diagnostic Accuracy Of Quantitative Flow Ratio In Myocardial Ischemia Of Coronary Artery Disease: A Meta-Analysis

2020 ◽  
Vol 36 (S1) ◽  
pp. 15-15
Author(s):  
Guo Huang ◽  
Di Xue
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Ischemia ◽  
Diagnostic Accuracy ◽  
Literature Search ◽  
Meta Analysis ◽  
Flow Ratio ◽  
Artery Disease ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

IntroductionQuantitative flow ratio (QFR) is a novel approach to derive fractional flow reserve (FFR) from coronary angiography. QFR based on 3-dimensional reconstruction of angiographic images assesses the significance of coronary artery disease (CAD) without using an invasive pressure wire. This study aimed to evaluate the diagnostic accuracy of quantitative flow ratio in myocardial ischemia of coronary artery disease.MethodsA meta-analysis was conducted of published research articles on diagnostic accuracy of QFR between January 2016 and September 2019 in the databases of PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform and China Bio-medicine Database. Statistical analysis was performed with software Meta-Disc 1.4 and Stata 12.0, and the summary receiver operating characteristic (SROC) curve was drawn to evaluate accuracy of the method.ResultsA total of 11 articles were retreived, including 1,782 patients and 2,054 vessels. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for quantitative flow ratio respectively, were 0.86 (95% confidence interval [CI]: 0.85-0.89), 0.89 (95%CI: 0.87–0.91), 7.51(95%CI: 6.40–8.82), 0.15 (95%CI: 0.10–0.23), 54.18 (95%CI: 34.09–86.12), and the pooled AUC was 0.9458.ConclusionsSeveral limitations should be considered when interpreting the findings of this meta-analysis. First, despite the extensive literature search, the number of included studies was small; however, the number of patients and vessels enrolled was satisfactory, thereby decreasing type II error. Furthermore, data acquisition is not comprehensive enough because the language of the literature search was limited to Chinese and English. Despite these limitations, our study suggests with a definition of ischemia as FFR ≤ 0.8, the QFR obtains high diagnostic efficacy in myocardial ischemia of CAD. It can be used as a non-invasive novel method to screen CAD patients with myocardial ischemia.

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