Fractional Flow Reserve Versus Instantaneous Wave‐Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study
Background The FiGARO (FFR versus iFR in Assessment of Hemodynamic Lesion Significance, and an Explanation of Their Discrepancies) trial is a prospective registry searching for predictors of fractional flow reserve/instantaneous wave‐free ratio (FFR/iFR) discrepancy. Methods and Results FFR/iFR were...
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| Language: | English |
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Wiley
2022-05-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.021490 |
| _version_ | 1798035911176355840 |
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| author | Tomas Kovarnik Matsuo Hitoshi Ales Kral Stepan Jerabek David Zemanek Yoshiaki Kawase Hiroyuki Omori Toru Tanigaki Jan Pudil Alexandra Vodzinska Marian Branny Roman Stipal Petr Kala Jan Mrozek Martin Porzer Tomas Grezl Kamil Novobilsky Oscar Mendiz Karel Kopriva Martin Mates Martin Chval Zhi Chen Pavel Martasek Ales Linhart |
| author_facet | Tomas Kovarnik Matsuo Hitoshi Ales Kral Stepan Jerabek David Zemanek Yoshiaki Kawase Hiroyuki Omori Toru Tanigaki Jan Pudil Alexandra Vodzinska Marian Branny Roman Stipal Petr Kala Jan Mrozek Martin Porzer Tomas Grezl Kamil Novobilsky Oscar Mendiz Karel Kopriva Martin Mates Martin Chval Zhi Chen Pavel Martasek Ales Linhart |
| author_sort | Tomas Kovarnik |
| collection | DOAJ |
| description | Background The FiGARO (FFR versus iFR in Assessment of Hemodynamic Lesion Significance, and an Explanation of Their Discrepancies) trial is a prospective registry searching for predictors of fractional flow reserve/instantaneous wave‐free ratio (FFR/iFR) discrepancy. Methods and Results FFR/iFR were analyzed using a Verrata wire, and coronary flow reserve was analyzed using a Combomap machine (both Philips‐Volcano). The risk polymorphisms for endothelial nitric oxide synthase and for heme oxygenase‐1 were analyzed. In total, 1884 FFR/iFR measurements from 1564 patients were included. The FFR/iFR discrepancy occurred in 393 measurements (20.9%): FFRp (positive)/iFRn (negative) type (264 lesions, 14.0%) and FFRn/iFRp (129 lesions, 6.8%) type. Coronary flow reserve was measured in 343 lesions, correlating better with iFR (R=0.56, P<0.0001) than FFR (R=0.36, P<0.0001). The coronary flow reserve value in FFRp/iFRn lesions (2.24±0.7) was significantly higher compared with both FFRp/iFRp (1.39±0.36), and FFRn/iFRn lesions (1.8±0.64, P<0.0001). Multivariable logistic regression analysis confirmed (1) sex, age, and lesion location in the right coronary artery as predictors for FFRp/iFRn discrepancy; and (2) hemoglobin level, smoking, and renal insufficiency as predictors for FFRn/iFRp discrepancy. The FFRn/iFRp type of discrepancy was significantly more frequent in patients with both risk types of polymorphisms (endothelial nitric oxide synthaser+heme oxygenase‐1r): 8 patients (24.2%) compared with FFRp/iFRn type of discrepancy: 2 patients (5.9%), P=0.03. Conclusions Predictors for FFRp/iFRn discrepancy were sex, age, and location in the right coronary artery. Predictors for FFRn/iFRp were hemoglobin level, smoking, and renal insufficiency. The risk type of polymorphism in endothelial nitric oxide synthase and heme oxygenase‐1 genes was more frequently found in patients with FFRn/iFRp type of discrepancy. Registration URL: https://clinicaltrials.gov; Unique identifier: NCT03033810. |
| first_indexed | 2024-04-11T21:04:54Z |
| format | Article |
| id | doaj.art-6dc7dee83dd241f5b3f1b2e5df6d619e |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-11T21:04:54Z |
| publishDate | 2022-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-6dc7dee83dd241f5b3f1b2e5df6d619e2022-12-22T04:03:23ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-05-0111910.1161/JAHA.121.021490Fractional Flow Reserve Versus Instantaneous Wave‐Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO StudyTomas Kovarnik0Matsuo Hitoshi1Ales Kral2Stepan Jerabek3David Zemanek4Yoshiaki Kawase5Hiroyuki Omori6Toru Tanigaki7Jan Pudil8Alexandra Vodzinska9Marian Branny10Roman Stipal11Petr Kala12Jan Mrozek13Martin Porzer14Tomas Grezl15Kamil Novobilsky16Oscar Mendiz17Karel Kopriva18Martin Mates19Martin Chval20Zhi Chen21Pavel Martasek22Ales Linhart232nd Department of Medicine Department of Cardiovascular Medicine First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech RepublicGifu Heart Center Gifu Japan2nd Department of Medicine Department of Cardiovascular Medicine First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech Republic2nd Department of Medicine Department of Cardiovascular Medicine First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech Republic2nd Department of Medicine Department of Cardiovascular Medicine First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech RepublicGifu Heart Center Gifu JapanGifu Heart Center Gifu JapanGifu Heart Center Gifu Japan2nd Department of Medicine Department of Cardiovascular Medicine First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech RepublicCardiology Department of Trinec Podlesi Hospital Trinec Czech RepublicCardiovascular Department University Hospital Ostrava Ostrava Czech RepublicDepartment of Internal Medicine and Cardiology University HospitalFaculty of MedicineMasaryk University Brno Brno Czech RepublicDepartment of Internal Medicine and Cardiology University HospitalFaculty of MedicineMasaryk University Brno Brno Czech RepublicCardiovascular Department University Hospital Ostrava Ostrava Czech RepublicCardiovascular Department University Hospital Ostrava Ostrava Czech RepublicCardiovascular Department University Hospital Ostrava Ostrava Czech RepublicCardiology Department Municipal Hospital Ostrava Ostrava Czech RepublicFundacion Favaloro Buenos Aires ArgentinaCardiology Department Homolka Hospital Prague Czech RepublicCardiology Department Homolka Hospital Prague Czech RepublicInstitute for Research and Development of Education Faculty of Education Charles University Prague Czech RepublicDepartment of Electrical & Computer Engineering Iowa Institute for Biomedical ImagingThe University of Iowa IADepartment of Paediatrics and Inherited Metabolic Disorders First Faculty of Medicine Charles UniversityGeneral University Hospital Prague Czech Republic2nd Department of Medicine Department of Cardiovascular Medicine First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech RepublicBackground The FiGARO (FFR versus iFR in Assessment of Hemodynamic Lesion Significance, and an Explanation of Their Discrepancies) trial is a prospective registry searching for predictors of fractional flow reserve/instantaneous wave‐free ratio (FFR/iFR) discrepancy. Methods and Results FFR/iFR were analyzed using a Verrata wire, and coronary flow reserve was analyzed using a Combomap machine (both Philips‐Volcano). The risk polymorphisms for endothelial nitric oxide synthase and for heme oxygenase‐1 were analyzed. In total, 1884 FFR/iFR measurements from 1564 patients were included. The FFR/iFR discrepancy occurred in 393 measurements (20.9%): FFRp (positive)/iFRn (negative) type (264 lesions, 14.0%) and FFRn/iFRp (129 lesions, 6.8%) type. Coronary flow reserve was measured in 343 lesions, correlating better with iFR (R=0.56, P<0.0001) than FFR (R=0.36, P<0.0001). The coronary flow reserve value in FFRp/iFRn lesions (2.24±0.7) was significantly higher compared with both FFRp/iFRp (1.39±0.36), and FFRn/iFRn lesions (1.8±0.64, P<0.0001). Multivariable logistic regression analysis confirmed (1) sex, age, and lesion location in the right coronary artery as predictors for FFRp/iFRn discrepancy; and (2) hemoglobin level, smoking, and renal insufficiency as predictors for FFRn/iFRp discrepancy. The FFRn/iFRp type of discrepancy was significantly more frequent in patients with both risk types of polymorphisms (endothelial nitric oxide synthaser+heme oxygenase‐1r): 8 patients (24.2%) compared with FFRp/iFRn type of discrepancy: 2 patients (5.9%), P=0.03. Conclusions Predictors for FFRp/iFRn discrepancy were sex, age, and location in the right coronary artery. Predictors for FFRn/iFRp were hemoglobin level, smoking, and renal insufficiency. The risk type of polymorphism in endothelial nitric oxide synthase and heme oxygenase‐1 genes was more frequently found in patients with FFRn/iFRp type of discrepancy. Registration URL: https://clinicaltrials.gov; Unique identifier: NCT03033810.https://www.ahajournals.org/doi/10.1161/JAHA.121.021490coronary flow reservefractional flow reserveinstantaneous wave‐free ratio |
| spellingShingle | Tomas Kovarnik Matsuo Hitoshi Ales Kral Stepan Jerabek David Zemanek Yoshiaki Kawase Hiroyuki Omori Toru Tanigaki Jan Pudil Alexandra Vodzinska Marian Branny Roman Stipal Petr Kala Jan Mrozek Martin Porzer Tomas Grezl Kamil Novobilsky Oscar Mendiz Karel Kopriva Martin Mates Martin Chval Zhi Chen Pavel Martasek Ales Linhart Fractional Flow Reserve Versus Instantaneous Wave‐Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease coronary flow reserve fractional flow reserve instantaneous wave‐free ratio |
| title | Fractional Flow Reserve Versus Instantaneous Wave‐Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study |
| title_full | Fractional Flow Reserve Versus Instantaneous Wave‐Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study |
| title_fullStr | Fractional Flow Reserve Versus Instantaneous Wave‐Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study |
| title_full_unstemmed | Fractional Flow Reserve Versus Instantaneous Wave‐Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study |
| title_short | Fractional Flow Reserve Versus Instantaneous Wave‐Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study |
| title_sort | fractional flow reserve versus instantaneous wave free ratio in assessment of lesion hemodynamic significance and explanation of their discrepancies international multicenter and prospective trial the figaro study |
| topic | coronary flow reserve fractional flow reserve instantaneous wave‐free ratio |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.021490 |
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