Influence of coronary calcification on hyperemic response during fractional flow reserve measurements

Borren, Nanette; Ottervanger, Jan Paul; Mouden, Mohamed; Dambrink, Jan-Henk; Timmer, Jorik R.; Jager, Piet L.

doi:10.1016/j.ijcard.2019.02.037

Cited by 1 publication

(2 citation statements)

References 27 publications

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“…However, calcification might have little effect on intracoronary pressure. Coronary artery calcification was not associated with the pressure gradient before and after the administration of adenosine [ 22 ]. Lesion length (82%), QCA-DS (64%), and minimum lumen diameter (55%) were reported as the most frequently used variables in the 11 clinical prediction models for FFR whereas calcification was only used in one of them (9%) [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

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Impact of calcification on Murray law-based quantitative flow ratio for physiological assessment of intermediate coronary stenoses

Zuo

Sun

et al. 2024

Cardiol J.

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Background To investigate the influence of coronary calcification on the diagnostic performance of Murray law-based quantitative flow ratio (μQFR) in identifying hemodynamically significant coronary lesions referenced to fractional flow reserve (FFR). Methods A total of 571 intermediate lesions from 534 consecutive patients (66.1 ± 10.0 years, 67.2% males) who underwent coronary angiography and simultaneous FFR measurement were included. Calcific deposits were graded by angiography as none or mild (spots), moderate (involving ≤ 50% of the reference vessel diameter), and severe (> 50%). Performance of μQFR to detect functional ischemia (FFR ≤ 0.80) was evaluated, including diagnostic parameters and areas under the receiver-operating curves (AUCs). Results The discrimination of ischemia by μQFR was comparable between none/mild and moderate/severe calcification (AUC: 0.91, 95% confidence interval: 0.88–0.93 vs. AUC: 0.87, 95% confidence interval: 0.78–0.94; p = 0.442). No statistically significant difference was observed for μQFR between the two categories in sensitivity (0.70 vs. 0.69, p = 0.861) and specificity (0.94 vs. 0.90, p = 0.192). Moreover, μQFR showed significantly higher AUCs than quantitative coronary angiographic diameter stenosis in both vessels with none/mild (0.91 vs. 0.78, p < 0.001) and moderate/severe calcification (0.87 vs. 0.69, p < 0.001). By multivariable analysis, there was no association between calcification and μQFR-FFR discordance (adjusted odds ratio: 1.529, 95% confidence interval: 0.788–2.968, p = 0.210) after adjustment for other confounding factors. Conclusions Murray law-based quantitative flow ratio demonstrated robust and superior diagnostic performance for lesion-specific ischemia compared with angiography alone regardless of coronary calcification.

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Section: Discussionmentioning

confidence: 99%

“…of adenosine [22]. Lesion length (82%), QCA-DS (64%), and minimum lumen diameter (55%) were reported as the most frequently used variables in the 11 clinical prediction models for FFR whereas calcification was only used in one of them (9%) [23].…”

Section: Discussionmentioning

confidence: 99%

Impact of calcification on Murray law-based quantitative flow ratio for physiological assessment of intermediate coronary stenoses

Zuo

Sun

et al. 2024

Cardiol J.

View full text Add to dashboard Cite

show abstract

Influence of coronary calcification on hyperemic response during fractional flow reserve measurements

Cited by 1 publication

References 27 publications

Impact of calcification on Murray law-based quantitative flow ratio for physiological assessment of intermediate coronary stenoses

Impact of calcification on Murray law-based quantitative flow ratio for physiological assessment of intermediate coronary stenoses

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