Three-Dimensional Angiographic Characteristics versus Functional Stenosis Severity in Fractional and Coronary Flow Reserve Discordance: A DEFINE FLOW Sub Study
Background: Coronary angiography alone is insufficient to identify lesions associated with myocardial ischemia that may benefit from revascularization. Coronary physiology parameters may improve clinical decision making in addition to coronary angiography, but the association between 2D and 3D quali...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/7/1770 |
| _version_ | 1797433686313926656 |
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| author | Valerie Stegehuis Jelmer Westra Coen Boerhout Martin Sejr-Hansen Ashkan Eftekhari Hernan Mejía-Renteria Maribel Cambero-Madera Niels Van Royen Hitoshi Matsuo Masafumi Nakayama Maria Siebes Evald Høj Christiansen Tim Van de Hoef Jan Piek |
| author_facet | Valerie Stegehuis Jelmer Westra Coen Boerhout Martin Sejr-Hansen Ashkan Eftekhari Hernan Mejía-Renteria Maribel Cambero-Madera Niels Van Royen Hitoshi Matsuo Masafumi Nakayama Maria Siebes Evald Høj Christiansen Tim Van de Hoef Jan Piek |
| author_sort | Valerie Stegehuis |
| collection | DOAJ |
| description | Background: Coronary angiography alone is insufficient to identify lesions associated with myocardial ischemia that may benefit from revascularization. Coronary physiology parameters may improve clinical decision making in addition to coronary angiography, but the association between 2D and 3D qualitative coronary angiography (QCA) and invasive pressure and flow measurements is yet to be elucidated. Methods: We associated invasive fractional flow reserve (FFR), coronary flow reserve (CFR) and coronary flow capacity (CFC) with 2D- and 3D-QCA in 430 intermediate lesions of 366 patients. Results: Overall, 2D-QCA analysis resulted in less severe stenosis severity compared with 3D-QCA analysis. FFR+/CFR− lesions had similar 3D-QCA characteristics as FFR+/CFR+ lesions. In contrast, vessels with FFR−/CFR+ discordance had 3D-QCA characteristics similar to those of vessels with concordant FFR−/CFR−. Contrarily, FFR+/CFR− lesions had CFC similar to that of as FFR-/CFR- lesions. Conclusions: Non-flow-limiting lesions (FFR+/CFR−) have 3D-QCA characteristics similar to those of FFR+/CFR+, but the majority are not associated with inducible myocardial ischemia as determined by invasive CFC. FFR−/CFR+ lesions have 3D-QCA characteristics similar to those of FFR−/CFR− lesions but are more frequently associated with a moderately to severely reduced CFC, illustrating the angiographic–functional mismatch in discordant lesions. |
| first_indexed | 2024-03-09T10:20:32Z |
| format | Article |
| id | doaj.art-a8da78858e604673aa536ef1bd2ea37a |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T10:20:32Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-a8da78858e604673aa536ef1bd2ea37a2023-12-01T22:04:28ZengMDPI AGDiagnostics2075-44182022-07-01127177010.3390/diagnostics12071770Three-Dimensional Angiographic Characteristics versus Functional Stenosis Severity in Fractional and Coronary Flow Reserve Discordance: A DEFINE FLOW Sub StudyValerie Stegehuis0Jelmer Westra1Coen Boerhout2Martin Sejr-Hansen3Ashkan Eftekhari4Hernan Mejía-Renteria5Maribel Cambero-Madera6Niels Van Royen7Hitoshi Matsuo8Masafumi Nakayama9Maria Siebes10Evald Høj Christiansen11Tim Van de Hoef12Jan Piek13Amsterdam UMC—Location AMC, Department of Cardiology, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, 1105 AZ Amsterdam, The NetherlandsDepartment of Cardiology, Aarhus University Hospital, Skejby, 8200 Aarhus, DenmarkAmsterdam UMC—Location AMC, Department of Cardiology, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, 1105 AZ Amsterdam, The NetherlandsDepartment of Cardiology, Aarhus University Hospital, Skejby, 8200 Aarhus, DenmarkDepartment of Cardiology, Aarhus University Hospital, Skejby, 8200 Aarhus, DenmarkDepartment of Cardiology, Hospital Clínico San Carlos IDISSC and Universidad Complutense de Madrid, 28040 Madrid, SpainTergooi Hospital, 1261 AN Blaricum, The NetherlandsDepartment of Cardiology, Radboud University Nijmegen, 6525 XZ Nijmegen, The NetherlandsGifu Heart Center, Gifu 500-8384, JapanGifu Heart Center, Gifu 500-8384, JapanAmsterdam UMC—Location AMC, Department of Biomedical Engineering and Physics, 1105 AZ Amsterdam, The NetherlandsDepartment of Cardiology, Aarhus University Hospital, Skejby, 8200 Aarhus, DenmarkAmsterdam UMC—Location AMC, Department of Cardiology, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, 1105 AZ Amsterdam, The NetherlandsAmsterdam UMC—Location AMC, Department of Cardiology, University of Amsterdam, Heart Center, Amsterdam Cardiovascular Sciences, 1105 AZ Amsterdam, The NetherlandsBackground: Coronary angiography alone is insufficient to identify lesions associated with myocardial ischemia that may benefit from revascularization. Coronary physiology parameters may improve clinical decision making in addition to coronary angiography, but the association between 2D and 3D qualitative coronary angiography (QCA) and invasive pressure and flow measurements is yet to be elucidated. Methods: We associated invasive fractional flow reserve (FFR), coronary flow reserve (CFR) and coronary flow capacity (CFC) with 2D- and 3D-QCA in 430 intermediate lesions of 366 patients. Results: Overall, 2D-QCA analysis resulted in less severe stenosis severity compared with 3D-QCA analysis. FFR+/CFR− lesions had similar 3D-QCA characteristics as FFR+/CFR+ lesions. In contrast, vessels with FFR−/CFR+ discordance had 3D-QCA characteristics similar to those of vessels with concordant FFR−/CFR−. Contrarily, FFR+/CFR− lesions had CFC similar to that of as FFR-/CFR- lesions. Conclusions: Non-flow-limiting lesions (FFR+/CFR−) have 3D-QCA characteristics similar to those of FFR+/CFR+, but the majority are not associated with inducible myocardial ischemia as determined by invasive CFC. FFR−/CFR+ lesions have 3D-QCA characteristics similar to those of FFR−/CFR− lesions but are more frequently associated with a moderately to severely reduced CFC, illustrating the angiographic–functional mismatch in discordant lesions.https://www.mdpi.com/2075-4418/12/7/1770coronaryphysiologyQCAfractional flow reservecoronary flow reserve |
| spellingShingle | Valerie Stegehuis Jelmer Westra Coen Boerhout Martin Sejr-Hansen Ashkan Eftekhari Hernan Mejía-Renteria Maribel Cambero-Madera Niels Van Royen Hitoshi Matsuo Masafumi Nakayama Maria Siebes Evald Høj Christiansen Tim Van de Hoef Jan Piek Three-Dimensional Angiographic Characteristics versus Functional Stenosis Severity in Fractional and Coronary Flow Reserve Discordance: A DEFINE FLOW Sub Study Diagnostics coronary physiology QCA fractional flow reserve coronary flow reserve |
| title | Three-Dimensional Angiographic Characteristics versus Functional Stenosis Severity in Fractional and Coronary Flow Reserve Discordance: A DEFINE FLOW Sub Study |
| title_full | Three-Dimensional Angiographic Characteristics versus Functional Stenosis Severity in Fractional and Coronary Flow Reserve Discordance: A DEFINE FLOW Sub Study |
| title_fullStr | Three-Dimensional Angiographic Characteristics versus Functional Stenosis Severity in Fractional and Coronary Flow Reserve Discordance: A DEFINE FLOW Sub Study |
| title_full_unstemmed | Three-Dimensional Angiographic Characteristics versus Functional Stenosis Severity in Fractional and Coronary Flow Reserve Discordance: A DEFINE FLOW Sub Study |
| title_short | Three-Dimensional Angiographic Characteristics versus Functional Stenosis Severity in Fractional and Coronary Flow Reserve Discordance: A DEFINE FLOW Sub Study |
| title_sort | three dimensional angiographic characteristics versus functional stenosis severity in fractional and coronary flow reserve discordance a define flow sub study |
| topic | coronary physiology QCA fractional flow reserve coronary flow reserve |
| url | https://www.mdpi.com/2075-4418/12/7/1770 |
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