Impact of Post-PCI FFR Stratified by Coronary Artery

Collet, Carlos; Johnson, Nils P.; Mizukami, Takuya; Fearon, William F.; Berry, Colin; Sonck, Jeroen; Collison, Damien; Koo, Bon-Kwon; Meneveau, Nicolas; Agarwal, Shiv Kumar; Uretsky, Barry; Hakeem, Abdul; Doh, Joon-Hyung; Da Costa, Bruno R.; Oldroyd, Keith G.; Leipsic, Jonathon A.; Morbiducci, Umberto; Taylor, Charles; Ko, Brian; Tonino, Pim A.L.; Perera, Divaka; Shinke, Toshiro; Chiastra, Claudio; Sposito, Andrei C.; Leone, Antonio Maria; Muller, Olivier; Fournier, Stephane; Matsuo, Hitoshi; Adjedj, Julien; Amabile, Nicolas; Piróth, Zsolt; Alfonso, Fernando; Rivero, Fernando; Ahn, Jung-Min; Toth, Gabor G.; Ihdayhid, Abdul; West, Nick E.J.; Amano, Tetsuya; Wyffels, Eric; Munhoz, Daniel; Belmonte, Marta; Ohashi, Hirofumi; Sakai, Koshiro; Gallinoro, Emanuele; Barbato, Emanuele; Engstrøm, Thomas; Escaned, Javier; Ali, Ziad A.; Kern, Morton J.; Pijls, Nico H.J.; Jüni, Peter; De Bruyne, Bernard

doi:10.1016/j.jcin.2023.08.018

Cited by 15 publications

(1 citation statement)

References 29 publications

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“…FFR measured after stent implantation have been found to be different in the left anterior descending artery (LAD) and the non-LAD arteries, with an impact on prognostic value. These differences correspond to the hydrostatic effect on a vessel-specific basis [ 7 ].…”

Section: The Effect Of Hydrostatic Pressure On Physiological Indicesmentioning

confidence: 99%

Pressure Never Lies, but It Should Be Interpreted Thoughtfully: The Role of Hydrostatic Pressure in Coronary Physiology

Kőszegi,

Szabó

2024

JPM

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Section: The Effect Of Hydrostatic Pressure On Physiological Indicesmentioning

confidence: 99%

Pressure Never Lies, but It Should Be Interpreted Thoughtfully: The Role of Hydrostatic Pressure in Coronary Physiology

Kőszegi,

Szabó

2024

JPM

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The effect of hydrostatic pressure on invasive coronary pressure measurements: Comparison with [¹⁵O]H₂O‐positron emission tomography flow data

Wilgenhof,

Jukema,

Driessen

et al. 2024

Cathet Cardio Intervent

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BackgroundFractional flow reserve (FFR) has emerged as the invasive gold standard for assessing vessel‐specific ischemia. However, FFR measurements are influenced by the hydrostatic effect, which might adversely impact the assessment of ischemia.AimsThis study aimed to investigate the impact of hydrostatic pressure on FFR measurements by correcting for the height and comparing FFR with [15O]H2O positron emission tomography (PET)‐derived relative flow reserve (RFR).MethodsThe 206 patients were included in this analysis. Patients underwent coronary computed tomography angiography (CCTA), [15O]H2O PET, and invasive coronary angiography with routine FFR in every epicardial artery. Height differences between the aortic guiding catheter and distal pressure sensor were quantified on CCTA images. An FFR ≤ 0.80 was considered significant.ResultsThe study found a reclassification in 7% of the coronary arteries. Notably, 11% of left anterior descending (LAD) arteries were reclassified from hemodynamically significant to nonsignificant. Conversely, 6% of left circumflex (Cx) arteries were reclassified from nonsignificant to significant. After correcting for the hydrostatic pressure effect, the correlation between FFR and PET‐derived RFR increased significantly from r = 0.720 to r = 0.786 (p = 0.009). The average magnitude of correction was +0.05 FFR units in the LAD, −0.03 in the Cx, and −0.02 in the right coronary artery.ConclusionHydrostatic pressure has a small but clinically relevant influence on FFR measurements obtained with a pressure wire. Correcting for this hydrostatic error significantly enhances the correlation between FFR and PET‐derived RFR.

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Physiological Performance of Drug‐Coated Balloons in Small Coronary Arteries PICCOLETO II μFR

Fezzi,

Trevisanello,

Buccheri

et al. 2024

Cathet Cardio Intervent

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BackgroundDrug‐coated balloons (DCB) are emerging as an alternative to permanent implants for managing de novo coronary artery disease, particularly in small vessels (SVD). This sub‐analysis of the PICCOLETO II study aimed to compare the performance of DCB and DES in terms of Murray's law‐based quantitative flow ratio (μFR) changes between baseline, post‐percutaneous coronary intervention (PCI), and follow‐up.MethodsPatients with a clinical indication for PCI were assigned to receive either Xience DES or Elutax SV/Emperor DCB. Coronary angiograms were blindly analyzed by an independent Core Laboratory (Consorzio Futuro in Ricerca, University of Ferrara, Italy).ResultsAmong 232 patients, 59 were included in this analysis. Pre‐PCI μFR was comparable between groups (0.65 ± 0.29 vs. 0.58 ± 0.25; p = 0.20). Post‐PCI, the DCB group had a lower acute functional gain compared to DES (+0.21 vs. +0.31; p = 0.064), with lower μFR values (0.86 ± 0.36 vs. 0.89 ± 0.3; p = 0.074). At 6‐month follow‐up, μFR values were similar between groups (0.84 ± 0.29 vs. 0.84 ± 0.31, p = 0.93), with a comparable late functional loss (−0.02 vs. −0.05; p = 0.93). Angiographic late lumen loss was significantly lower in the DCB group (−0.03 vs. +0.29 mm; p = 0.027).ConclusionsDCB‐based PCI showed a trend toward less favorable immediate post‐PCI functional result but a comparable performance at follow‐up, suggesting its potential in treating de novo SVD.

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Impact of Post-PCI FFR Stratified by Coronary Artery

Cited by 15 publications

References 29 publications

Pressure Never Lies, but It Should Be Interpreted Thoughtfully: The Role of Hydrostatic Pressure in Coronary Physiology

Pressure Never Lies, but It Should Be Interpreted Thoughtfully: The Role of Hydrostatic Pressure in Coronary Physiology

The effect of hydrostatic pressure on invasive coronary pressure measurements: Comparison with [¹⁵O]H₂O‐positron emission tomography flow data

Physiological Performance of Drug‐Coated Balloons in Small Coronary Arteries PICCOLETO II μFR

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Impact of Post-PCI FFR Stratified by Coronary Artery

Cited by 15 publications

References 29 publications

Pressure Never Lies, but It Should Be Interpreted Thoughtfully: The Role of Hydrostatic Pressure in Coronary Physiology

Pressure Never Lies, but It Should Be Interpreted Thoughtfully: The Role of Hydrostatic Pressure in Coronary Physiology

The effect of hydrostatic pressure on invasive coronary pressure measurements: Comparison with [15O]H2O‐positron emission tomography flow data

Physiological Performance of Drug‐Coated Balloons in Small Coronary Arteries PICCOLETO II μFR

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The effect of hydrostatic pressure on invasive coronary pressure measurements: Comparison with [¹⁵O]H₂O‐positron emission tomography flow data