Predictive factors of discordance between the instantaneous wave-free ratio and fractional flow reserve.

Détails

ID Serval
serval:BIB_46E6712C4E5C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Predictive factors of discordance between the instantaneous wave-free ratio and fractional flow reserve.
Périodique
Catheterization and cardiovascular interventions
Auteur(s)
Dérimay F., Johnson N.P., Zimmermann F.M., Adjedj J., Witt N., Hennigan B., Koo B.K., Barbato E., Esposito G., Trimarco B., Rioufol G., Park S.J., Baptista S.B., Chrysant G.S., Leone A.M., Jeremias A., Berry C., De Bruyne B., Oldroyd K.G., Pijls NHJ, Fearon W.F.
ISSN
1522-726X (Electronic)
ISSN-L
1522-1946
Statut éditorial
In Press
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Résumé
To identify clinical, angiographic and hemodynamic predictors of discordance between instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR).
The iFR was found to be non-inferior to the gold-standard FFR for guiding coronary revascularization, although it is discordant with FFR in 20% of cases. A better understanding of the causes of discordance may enhance application of these indices.
Both FFR and iFR were measured in the prospective multicenter CONTRAST study. Clinical, angiographic and hemodynamic variables were compared between patients with concordant values of FFR and iFR (cutoff ≤0.80 and ≤0.89, respectively).
Out of the 587 patients included, in 466 patients (79.4%) FFR and iFR agreed: both negative, n = 244 (41.6%), or positive, n = 222 (37.8%). Compared with FFR, iFR was negative discordant (FFR+/iFR-) in 69 (11.8%) patients and positive discordant (FFR-/iFR+) in 52 (8.9%) patients. On multivariate regression, stenosis location (left main or proximal left anterior descending) (OR: 3.30[1.68;6.47]), more severe stenosis (OR: 1.77[1.35;2.30]), younger age (OR: 0.93[0.90;0.97]), and slower heart rate (OR: 0.59[0.42;0.75]) were predictors of a negative discordant iFR. Absence of a beta-blocker (OR: 0.41[0.22;0.78]), older age (OR: 1.04[1.00;1.07]), and less severe stenosis (OR: 0.69[0.53;0.89]) were predictors of a positive discordant iFR.
During iFR acquisition, stenosis location, stenosis degree, heart rate, age and use of beta blockers influence concordance with FFR and should be taken into account when interpreting iFR.
Mots-clé
coronary physiology, fractional flow reserve, instantaneous wave-free ratio
Pubmed
Création de la notice
25/03/2019 9:56
Dernière modification de la notice
21/08/2019 6:11
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