CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

Active factor XI is associated with the risk of cardiovascular events in stable coronary artery disease patients Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation Comparative efficacy of two paclitaxel-coated balloons with different excipient coatings in patients with coronary in-stent restenosis: A pooled analysis of the Intracoronary Stenting and Angiographic Results: Optimizing Treatment of Drug Eluting Stent In-Stent Restenosis 3 and 4 trials EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion – an update New Evidence Supporting a Novel Conceptual Framework for Distinguishing Proportionate and Disproportionate Functional Mitral Regurgitation Contemporary prevalence of pulmonary arterial hypertension in adult congenital heart disease following the updated clinical classification Left main coronary angioplasty: early and late results of 127 acute and elective procedures Long-Term Outcomes of Different Two-Stent Techniques With Second-Generation Drug-Eluting Stents for Unprotected Left Main Bifurcation Disease: Insights From the FAILS-2 Study Rotational Atherectomy in acute STEMI with heavily calcified culprit lesion is a rule breaking solution Pulmonary vascular lesions occurring in patients with chronic major vessel thromboembolic pulmonary hypertension

Original Research2017 Dec;30(6):564-569.

JOURNAL:J Interv Cardiol. Article Link

Diagnostic accuracy of instantaneous wave free-ratio in clinical practice

Ding WY, Nair S, Appleby C. Keywords: fractional flow reserve; functional testing; instantaneous wave-free ratio; pressure wire studies

ABSTRACT


AIMS - To evaluate the correlation between iFR and FFR in real-world clinical practice.


METHODS AND RESULTS - Retrospective, single-centre study of 229 consecutive pressure-wire studies (np  = 158). Real-time iFR and FFR measurements were performed for angiographically borderline stenoses. Functionally significant stenoses were defined as iFR <0.86 or FFR ≤0.80. An iFR between 0.86 and 0.93 was considered within the grey zone (Hybrid approach). Median iFR and FFR (IQR) were 0.92 (0.87-0.95) and 0.83 (0.76-0.89), respectively. Pearson's correlation coefficient was 0.75 (P < 0.001). Bland-Altman plot showed a mean difference between iFR and FFR that remained consistent throughout the range of values. The optimal iFR cutoff was 0.91-sensitivity 80%, specificity 82% with ROC area under curve of 89%. Using the Hybrid iFR-FFR strategy, we demonstrated high accuracy of iFR results-sensitivity 95%, specificity 96%, PPV 95%, and NPV 96%. In addition, this method would have avoided adenosine in 56% of patients. Mean follow-up period was 17.2 (±3.4) months. All-cause mortality was 3.2% (np = 5) and repeat intervention was required in six lesions (2.6%).


CONCLUSIONS - This study demonstrates that iFR is a valuable adjunct to FFR using the Hybrid iFR-FFR strategy in a real-world population. The use of adenosine may be avoided in about half the cases.


© 2017, Wiley Periodicals, Inc.