Barbara E Stähli1, Aslihan Erbay1, Julia Steiner1, Jens Klotsche2, Hans-Christian Mochmann1, Carsten Skurk1, Alexander Lauten1, Ulf Landmesser3, David M Leistner4. 1. Department of Cardiology, Charité Berlin - University Medicine, Campus Benjamin Franklin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany. 2. German Rheumatism Research Center Berlin, Berlin, Germany; Institute for Epidemiology and Health Care Economics, Charité Berlin - University Medicine, Campus Mitte, Berlin, Germany. 3. Department of Cardiology, Charité Berlin - University Medicine, Campus Benjamin Franklin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany. 4. Department of Cardiology, Charité Berlin - University Medicine, Campus Benjamin Franklin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany. Electronic address: david-manuel.leistner@charite.de.
Abstract
BACKGROUND: Quantitative flow ratio (QFR) is a novel, adenosine-free method for functional coronary lesion interrogation, which is based on 3-dimensional quantitative coronary angiography and computational algorithms. Data on QFR in all-comer patients with intermediate coronary lesions are scarce, and the diagnostic performance in comparison to resting distal to aortic coronary pressure (Pd/Pa) ratio unknown. METHODS: A total of 436 patients with 516 vessels undergoing FFR measurements were included in the analysis. Diagnostic performance of QFR, distal to aortic coronary pressure (Pd/Pa) ratio, and anatomic indices versus FFR was assessed. RESULTS: FFR ≤0.80 was measured in 19.4% of interrogated vessels. QFR significantly correlated with FFR (r = 0.82, p < 0.001) with good agreement between QFR and FFR (mean difference 0.011, 95% CI 0.008-0.015). The AUC for an FFR ≤0.80 was 0.86 (95% CI 0.83-0.89, p < 0.001) for QFR, 0.76 (0.72-0.80, p < 0.001) for resting Pd/Pa ratio, and 0.63 (0.59-0.67, p < 0.001) for diameter stenosis. The diagnostic accuracy for identifying an FFR ≤0.80 was 93.4% for QFR, 84.3% for resting Pd/Pa ratio, and 80.4% for diameter stenosis. CONCLUSIONS: QFR provides a novel diagnostic tool for functional coronary lesion assessment with superior diagnostic accuracy as compared with resting Pd/Pa ratio and anatomic indices. Future studies are needed to determine the non-inferiority of QFR analysis to FFR assessment with respect to clinical outcomes.
BACKGROUND: Quantitative flow ratio (QFR) is a novel, adenosine-free method for functional coronary lesion interrogation, which is based on 3-dimensional quantitative coronary angiography and computational algorithms. Data on QFR in all-comer patients with intermediate coronary lesions are scarce, and the diagnostic performance in comparison to resting distal to aortic coronary pressure (Pd/Pa) ratio unknown. METHODS: A total of 436 patients with 516 vessels undergoing FFR measurements were included in the analysis. Diagnostic performance of QFR, distal to aortic coronary pressure (Pd/Pa) ratio, and anatomic indices versus FFR was assessed. RESULTS: FFR ≤0.80 was measured in 19.4% of interrogated vessels. QFR significantly correlated with FFR (r = 0.82, p < 0.001) with good agreement between QFR and FFR (mean difference 0.011, 95% CI 0.008-0.015). The AUC for an FFR ≤0.80 was 0.86 (95% CI 0.83-0.89, p < 0.001) for QFR, 0.76 (0.72-0.80, p < 0.001) for resting Pd/Pa ratio, and 0.63 (0.59-0.67, p < 0.001) for diameter stenosis. The diagnostic accuracy for identifying an FFR ≤0.80 was 93.4% for QFR, 84.3% for resting Pd/Pa ratio, and 80.4% for diameter stenosis. CONCLUSIONS: QFR provides a novel diagnostic tool for functional coronary lesion assessment with superior diagnostic accuracy as compared with resting Pd/Pa ratio and anatomic indices. Future studies are needed to determine the non-inferiority of QFR analysis to FFR assessment with respect to clinical outcomes.
Authors: Aslihan Erbay; Lisa Penzel; Youssef S Abdelwahed; Jens Klotsche; Anne-Sophie Schatz; Julia Steiner; Arash Haghikia; Ulf Landmesser; Barbara E Stähli; David M Leistner Journal: Int J Cardiovasc Imaging Date: 2021-03-02 Impact factor: 2.357
Authors: Mina Ghobrial; Hazel Arfah Haley; Rebecca Gosling; Vignesh Rammohan; Patricia V Lawford; D Rod Hose; Julian P Gunn; Paul D Morris Journal: Heart Date: 2021-01-08 Impact factor: 5.994
Authors: Hazel Arfah Haley; Mina Ghobrial; Paul D Morris; Rebecca Gosling; Gareth Williams; Mark T Mills; Tom Newman; Vignesh Rammohan; Giulia Pederzani; Patricia V Lawford; Rodney Hose; Julian P Gunn Journal: Front Cardiovasc Med Date: 2021-10-22
Authors: Roshni Solanki; Rebecca Gosling; Vignesh Rammohan; Giulia Pederzani; Pankaj Garg; James Heppenstall; D Rodney Hose; Patricia V Lawford; Andrew J Narracott; John Fenner; Julian P Gunn; Paul D Morris Journal: Sci Rep Date: 2021-10-04 Impact factor: 4.996