Clinical Outcome of Lesions With Discordant Results Among Different Invasive Physiologic Indices　― Resting Distal Coronary to Aortic Pressure Ratio, Resting Full-Cycle Ratio, Diastolic Pressure Ratio, Instantaneous Wave-Free Ratio, and Fractional Flow Reserve ―

Lee, Joo Myung; Rhee, Tae Min; Choi, Gi Hong; Park, Jonghanne; Hwang, Doyeon; Kim, Jinseob; Park, Jinhyoung; Kim, Hyung Yoon; Jung, Hae Won; Yoon, Hyuck Jun; Song, Young Bin; Hahn, Joo Yong; Nam, Chang Wook; Shin, Eun Seok; Doh, Joon Hyung; Hur, Seung Ho; Koo, Bon Kwon

doi:10.1253/circj.cj-19-0230

Cited by 44 publications

(31 citation statements)

References 26 publications

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“…A comparative study of FFR and resting indices found that FFR and resting indices are lower in the LAD than in non‐LAD arteries . We found that the FFR and RFR were significantly lower in the LAD than in non‐LAD arteries.…”

Section: Discussionmentioning

confidence: 45%

“…16 A comparative study of FFR and resting indices found that FFR and resting indices are lower in the LAD than in non-LAD arteries. [17][18][19] We found that the FFR and RFR were significantly lower in the LAD than in non-LAD arteries. Lee et al 20 reported that the prevalence of discordance was highest between FFR and iFR, being 20.7, 7.8, and 6.0% for the LAD, LCX, and RCA, respectively (p = .001).…”

Section: Concordance Between Ffr and Rfrmentioning

confidence: 68%

“…Lee et al reported that discordance between resting physiological indices and FFR and resting indices were not associated with increased risk of vessel‐oriented composite outcomes in deferred lesions after 2 years. Moreover, Lee et al reported that FFR–iFR discordance is not associated with increased risk of patient‐oriented composite outcomes among patients with deferred lesions at 5 years.…”

Section: Discussionmentioning

confidence: 99%

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Relationship between resting full‐cycle ratio and fractional flow reserve in assessments of coronary stenosis severity

Muroya

Kawano

Hata

et al. 2020

Cathet Cardio Intervent

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Aim: Comparisons between the resting full-cycle ratio (RFR), a new physiological resting index, and fractional flow reserve (FFR) in terms of prognostic value are limited. We aimed to identify the prognostic value of concordance between RFR and FFR and to determine the stability of measured RFR. Methods and Results: We measured FFR and RFR in 161 coronary arteries of 119 patients and classified the data using known cutoffs for FFR (≤0.80) and RFR (≤0.89) into groups; high FFR and high RFR (high FFR/low RFR) group, high FFR and low RFR (high FFR/low RFR) group, low FFR and high RFR (low FFR/high RFR) group, and low FFR and low RFR (low FFR/low RFR) group. The concordance rates in these groups were 42.2% (68/161), 4.4% (7/161), 14.3% (23/161), and 39.1% (63/161), respectively. The concordance between FFR and RFR was 81.4%. The prevalence of females was significantly higher, values for hemoglobin values were significantly lower, and average E/E 0 (an index of left ventricular (LV) diastolic function by echocardiography) was significantly higher in high FFR/low RFR group than in low FFR/high RFR group (p = .008, .050, and .028, respectively). Conclusions: The RFR and FFR values consistently agreed. Female, anemia, and LV diastolic dysfunction may be related to the difference of discordance between high FFR/low RFR and low FFR/high RFR.

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Section: Discussionmentioning

confidence: 45%

Section: Concordance Between Ffr and Rfrmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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Relationship between resting full‐cycle ratio and fractional flow reserve in assessments of coronary stenosis severity

Muroya

Kawano

Hata

et al. 2020

Cathet Cardio Intervent

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“…to previous smaller studies with a range from 7.2-19.7% (14,22,(26)(27)(28). This may be attributed to the broad inclusion criteria, which may affect physiologic measurements and cause discrepancies (21).…”

Section: Values Are N (%) or N (95% Confidence Interval)mentioning

confidence: 87%

Comparison of Resting Full-Cycle Ratio and Fractional Flow Reserve in a German Real-World Cohort

Wienemann

Meyer

Mauri

et al. 2021

Front. Cardiovasc. Med.

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Objective: The aim of this study was to evaluate non-hyperemic resting pressure ratios (NHPRs), especially the novel “resting full-cycle ratio” (RFR; lowest pressure distal to the stenosis/aortic pressure during the entire cardiac cycle), compared to the gold standard fractional flow reserve (FFR) in a “real-world” setting.Methods: The study included patients undergoing coronary pressure wire studies at one German University Hospital. No patients were excluded based on any baseline or procedural characteristics, except for insufficient quality of traces. The diagnostic performance of four NHPRs vs. FFR ≤ 0.80 was tested. Morphological characteristics of stenoses were analyzed by quantitative coronary angiography.Results: 617 patients with 712 coronary lesions were included. RFR showed a significant correlation with FFR (r = 0.766, p < 0.01). Diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of RFR were 78% (95% confidence interval = 75; 81), 72% (65; 78), 81% (77; 84), 63% (57; 69), and 86% (83; 89). Relevant predictors for discordance of RFR ≤ 0.89/FFR > 0.8 were LAD lesions, peripheral artery disease, age, female sex and non-focal stenoses. Predictors for discordance of RFR > 0.89/FFR ≤ 0.8 included non-LCX lesions, percent diameter stenosis and previous percutaneous coronary intervention in the target vessel. RFR and all other NHPRs were highly correlated with each other.Conclusion: All NHPRs have a similar correlation with the gold standard FFR and may facilitate the acceptance and implementation of physiological assessments of lesion severity. However, we found ~20% discordant results between NHPRs and FFR in our “all-comers” German cohort.

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“…4,5 FFR and iFR are reportedly discordant in up to 20% of cases. [6][7][8][9][10][11][12] The iFR is calculated as the coronary artery distal pressure (Pd) to aortic pressure (Pa) ratio (Pd/Pa) in the absence of were performed in the standard manner. The Volcano S5 imaging system with the Verrata pressure guide-wire (Phillips, Amsterdam, Netherlands) was used for measuring coronary artery pressure.…”

mentioning

confidence: 99%

Diagnostic Performance and Pressure Stability of a Novel Myocardial Ischemic Diagnostic Index　― The Intracoronary-Electrocardiogram-Triggered Distal Pressure/Aortic Pressure Ratio ―

Nakayama

Uchiyama²,

Tanaka

et al. 2020

Circ Rep

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Background: We hypothesized that the intracoronary-electrocardiogram (IC-ECG)-based pressure index would be more stable and precise than the instantaneous flow reserve (iFR). We investigated the usefulness of the IC-ECG-based pressure index for diagnosing myocardial ischemia. Methods and Results: Thirty-seven consecutive patients with coronary stenosis requiring physiological assessment were enrolled in the study. iFR was measured at rest and under hyperemia in 51 and 40 lesions, respectively. The IC-ECG-triggered distal pressure (Pd)/aortic pressure (Pa) ratio (ICE-T) was defined as the mean Pd/Pa ratio in the period corresponding to the isoelectric line. The ICE-T was significantly lower than the iFR both at rest and during hyperemia (P<0.00001 for both). Fluctuations in the ICE-T pressure parameters (Pd/Pa, Pa, and Pd) were significantly smaller than those of iFR both at rest and during hyperemia. The diagnostic accuracy of predicting a fractional flow reserve (FFR) ≤0.80 of the ICE-T at rest was significantly higher than that of iFR (P=0.008). Receiver operating characteristic curve analyses showed that the ICE-T predicts FFR ≤0.80 more accurately than the iFR (area under curve 0.897 vs. 0.810 for ICE-T and iFR, respectively). Conclusions: We identified the period in the IC-ECG in which resting Pd/Pa was low and constant. The IC-ECG-based algorithm may improve the accuracy of diagnosing myocardial ischemia, without increasing invasiveness, compared with pressure-dependent indices.

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Clinical Outcome of Lesions With Discordant Results Among Different Invasive Physiologic Indices　― Resting Distal Coronary to Aortic Pressure Ratio, Resting Full-Cycle Ratio, Diastolic Pressure Ratio, Instantaneous Wave-Free Ratio, and Fractional Flow Reserve ―

Cited by 44 publications

References 26 publications

Relationship between resting full‐cycle ratio and fractional flow reserve in assessments of coronary stenosis severity

Relationship between resting full‐cycle ratio and fractional flow reserve in assessments of coronary stenosis severity

Comparison of Resting Full-Cycle Ratio and Fractional Flow Reserve in a German Real-World Cohort

Diagnostic Performance and Pressure Stability of a Novel Myocardial Ischemic Diagnostic Index　― The Intracoronary-Electrocardiogram-Triggered Distal Pressure/Aortic Pressure Ratio ―

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Clinical Outcome of Lesions With Discordant Results Among Different Invasive Physiologic Indices ― Resting Distal Coronary to Aortic Pressure Ratio, Resting Full-Cycle Ratio, Diastolic Pressure Ratio, Instantaneous Wave-Free Ratio, and Fractional Flow Reserve ―

Cited by 44 publications

References 26 publications

Relationship between resting full‐cycle ratio and fractional flow reserve in assessments of coronary stenosis severity

Relationship between resting full‐cycle ratio and fractional flow reserve in assessments of coronary stenosis severity

Comparison of Resting Full-Cycle Ratio and Fractional Flow Reserve in a German Real-World Cohort

Diagnostic Performance and Pressure Stability of a Novel Myocardial Ischemic Diagnostic Index ― The Intracoronary-Electrocardiogram-Triggered Distal Pressure/Aortic Pressure Ratio ―

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Clinical Outcome of Lesions With Discordant Results Among Different Invasive Physiologic Indices　― Resting Distal Coronary to Aortic Pressure Ratio, Resting Full-Cycle Ratio, Diastolic Pressure Ratio, Instantaneous Wave-Free Ratio, and Fractional Flow Reserve ―

Diagnostic Performance and Pressure Stability of a Novel Myocardial Ischemic Diagnostic Index　― The Intracoronary-Electrocardiogram-Triggered Distal Pressure/Aortic Pressure Ratio ―