BACKGROUND: We undertook a prospective study to assess the impact of routine incorporation of right atrial pressure into the calculation of FFR in a real world elective PCI cohort. METHODS: 42 patients with stenoses in 2 separate epicardial vessels at coronary angiography were studied. Using a temperature and pressure sensing guidewire (TPSG) FFR and FFRRAP were performed in the target vessel pre and post PCI and in a non-target vessel. FFR was defined as Pd/Pa, FFRRAP as Pd-Pv/Pa-Pv where Pv was right atrial pressure and Pd/Pa were the hyperemic distal and proximal arterial pressures respectively. RESULTS: Mean RAP was 9.1 ± 0.7 mmHg. Mean FFR was significantly lower when RAP was included in the calculation (FFRRAP 0.77 ± 0.19 vs. FFR 0.80 ± 0.16, p<0.001). In the target vessel pre PCI, incorporating RAP into the calculation of FFR resulted in a significant difference in the FFR value (FFR Pre-PCI 0.69 ± 0.02 vs. FFRRAP Pre-PCI 0.63 ± 0.03, p<0.0001). 21 patients had an FFR ≤ 0.8 in the group. If right atrial pressure were utilized to calculate FFR prior to PCI, an additional 9 patients would have been re-categorised to an FFR ≤ 0.8. Following PCI, mean FFR was lower when RAP was incorporated (Post PCI FFRRAP 0.93±0.05 vs. Post PCI FFR 0.95 ± 0.06, p<0.001). CONCLUSION: Incorporation of right atrial pressure into the calculation of FFR significantly alters FFR values and may potentially reclassify lesions below ischaemic thresholds. Crown
BACKGROUND: We undertook a prospective study to assess the impact of routine incorporation of right atrial pressure into the calculation of FFR in a real world elective PCI cohort. METHODS: 42 patients with stenoses in 2 separate epicardial vessels at coronary angiography were studied. Using a temperature and pressure sensing guidewire (TPSG) FFR and FFRRAP were performed in the target vessel pre and post PCI and in a non-target vessel. FFR was defined as Pd/Pa, FFRRAP as Pd-Pv/Pa-Pv where Pv was right atrial pressure and Pd/Pa were the hyperemic distal and proximal arterial pressures respectively. RESULTS: Mean RAP was 9.1 ± 0.7 mmHg. Mean FFR was significantly lower when RAP was included in the calculation (FFRRAP 0.77 ± 0.19 vs. FFR 0.80 ± 0.16, p<0.001). In the target vessel pre PCI, incorporating RAP into the calculation of FFR resulted in a significant difference in the FFR value (FFR Pre-PCI 0.69 ± 0.02 vs. FFRRAP Pre-PCI 0.63 ± 0.03, p<0.0001). 21 patients had an FFR ≤ 0.8 in the group. If right atrial pressure were utilized to calculate FFR prior to PCI, an additional 9 patients would have been re-categorised to an FFR ≤ 0.8. Following PCI, mean FFR was lower when RAP was incorporated (Post PCI FFRRAP 0.93±0.05 vs. Post PCI FFR 0.95 ± 0.06, p<0.001). CONCLUSION: Incorporation of right atrial pressure into the calculation of FFR significantly alters FFR values and may potentially reclassify lesions below ischaemic thresholds. Crown
Authors: Robert A Leonardi; Jacob C Townsend; Chetan A Patel; Bethany J Wolf; Thomas M Todoran; Valerian L Fernandes; Christopher D Nielsen; Daniel H Steinberg; Eric R Powers Journal: Cardiovasc Revasc Med Date: 2013-07-23
Authors: Tobias Härle; Mareike Luz; Sven Meyer; Felix Vahldiek; Pim van der Harst; Randy van Dijk; Daan Ties; Javier Escaned; Justin Davies; Albrecht Elsässer Journal: Clin Res Cardiol Date: 2017-11-02 Impact factor: 5.460
Authors: Yousif Ahmad; Matthias Götberg; Christopher Cook; James P Howard; Iqbal Malik; Ghada Mikhail; Angela Frame; Ricardo Petraco; Christopher Rajkumar; Ozan Demir; Juan F Iglesias; Ravinay Bhindi; Sasha Koul; Nearchos Hadjiloizou; Robert Gerber; Punit Ramrakha; Neil Ruparelia; Nilesh Sutaria; Gajen Kanaganayagam; Ben Ariff; Michael Fertleman; Jon Anderson; Andrew Chukwuemeka; Darrel Francis; Jamil Mayet; Patrick Serruys; Justin Davies; Sayan Sen Journal: JACC Cardiovasc Interv Date: 2018-08-25 Impact factor: 11.195
Authors: Yousif Ahmad; Jeroen Vendrik; Ashkan Eftekhari; James P Howard; Christopher Cook; Christopher Rajkumar; Iqbal Malik; Ghada Mikhail; Neil Ruparelia; Nearchos Hadjiloizou; Sukhjinder Nijjer; Rasha Al-Lamee; Ricardo Petraco; Takayuki Warisawa; Gilbert W M Wijntjens; Karel T Koch; Tim van de Hoef; Guus de Waard; Mauro Echavarria-Pinto; Angela Frame; Nilesh Sutaria; Gajen Kanaganayagam; Ben Ariff; Jon Anderson; Andrew Chukwuemeka; Michael Fertleman; Sasha Koul; Juan F Iglesias; Darrel Francis; Jamil Mayet; Patrick Serruys; Justin Davies; Javier Escaned; Niels van Royen; Matthias Götberg; Christian Juhl Terkelsen; Evald Høj Christiansen; Jan J Piek; Jan Baan; Sayan Sen Journal: Circ Cardiovasc Interv Date: 2019-11-22 Impact factor: 6.546