CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

The year in cardiovascular medicine 2020: heart failure and cardiomyopathies Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age: Insights From DAPA-HF Prdm16 Deficiency Leads to Age-Dependent Cardiac Hypertrophy, Adverse Remodeling, Mitochondrial Dysfunction, and Heart Failure Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis Impact of the Use of Intravascular Imaging on Patients Who Underwent Orbital Atherectomy Unexpectedly Low Natriuretic Peptide Levels in Patients With Heart Failure Fractional flow reserve derived from CCTA may have a prognostic role in myocardial bridging Nitrosative stress drives heart failure with preserved ejection fraction Attenuated plaque detected by intravascular ultrasound: clinical, angiographic, and morphologic features and post-percutaneous coronary intervention complications in patients with acute coronary syndromes Association of Left Ventricular Systolic Function With Incident Heart Failure in Late Life

Clinical TrialVolume 11, Issue 15, August 2018

JOURNAL:JACC Cardiovasc Interv. Article Link

Sex Differences in Adenosine-Free Coronary Pressure Indexes - A CONTRAST Substudy

SV Shah, FM Zimmermann, NP Johnson et al. Keywords: contrast fractional flow reserve; fractional flow reserve; sex differences

ABSTRACT


OBJECTIVES - The goal of this study was to investigate sex differences in adenosine-free coronary pressure indexes.


BACKGROUND - Several adenosine-free coronary pressure wire indexes have been proposed to assess the functional significance of coronary artery lesions; however, there is a theoretical concern that sex differences may affect diagnostic performance because of differences in resting flow and distal myocardial mass.

METHODS - In this CONTRAST (Can Contrast Injection Better Approximate FFR Compared to Pure Resting Physiology?) substudy, contrast fractional flow reserve (cFFR), obtained during contrast-induced submaximal hyperemia, the instantaneous wave-free ratio (iFR), and distal/proximal coronary pressure ratio (Pd/Pa) were compared with fractional flow reserve (FFR) in 547 men and 216 women. Using FFR ≤0.8 as a reference, the diagnostic performance of each index was compared.

RESULTS - Men and women had similar diameter stenosis (p = 0.78), but women were less likely to have FFR ≤0.80 than men (42.5% vs. 51.5%, p = 0.04). Sensitivity was similar among cFFR, iFR, and Pd/Pa when comparing women and men, respectively (cFFR, 77.5% vs. 75.3%; p = 0.69; iFR, 84.9% vs. 79.4%; p = 0.30; Pd/Pa, 78.8% vs. 77.3%; p = 0.78). cFFR was more specific than iFR or Pd/Pa regardless of sex (cFFR, 94.3% vs. 95.8%; p = 0.56; iFR, 75.6% vs. 80.1%; p = 0.38; Pd/Pa, 80.6% vs. 78.7%; p = 0.69). By receiver-operating characteristic curve analysis, cFFR provided better diagnostic accuracy than resting indexes irrespective of sex (p ≤ 0.0001).

CONCLUSIONS - Despite the theoretical concern, the diagnostic sensitivity and specificity of cFFR, iFR, and Pd/Pa did not differ between the sexes. Irrespective of sex, cFFR provides the best diagnostic performance.