Predictors of discordance between fractional flow reserve (FFR) and diastolic pressure ratio (dPR) in intermediate coronary lesions
Background: Recently, non-hyperemic pressure ratios (NHPRs) have been validated as a reliable alternative to fractional flow reserve (FFR). However, a discordance between FFR and NHPRs is observed in 20–25% of cases. The aim of this study is to evaluate predictors of discordance between FFR and dias...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906723000489 |
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| author | Alessandra Scoccia Tara Neleman Annemieke C. Ziedses des Plantes Frederik T.W. Groenland Jurgen M R Ligthart Wijnand K. den Dekker Roberto Diletti Jeroen Wilschut Rutger Jan Nuis Felix Zijlstra Eric Boersma Nicolas M Van Mieghem Joost Daemen |
| author_facet | Alessandra Scoccia Tara Neleman Annemieke C. Ziedses des Plantes Frederik T.W. Groenland Jurgen M R Ligthart Wijnand K. den Dekker Roberto Diletti Jeroen Wilschut Rutger Jan Nuis Felix Zijlstra Eric Boersma Nicolas M Van Mieghem Joost Daemen |
| author_sort | Alessandra Scoccia |
| collection | DOAJ |
| description | Background: Recently, non-hyperemic pressure ratios (NHPRs) have been validated as a reliable alternative to fractional flow reserve (FFR). However, a discordance between FFR and NHPRs is observed in 20–25% of cases. The aim of this study is to evaluate predictors of discordance between FFR and diastolic Pressure ratio (dPR). Methods: PREDICT is a retrospective, single center, investigator-initiated study including 813 patients (1092vessels) who underwent FFR assessment of intermediate coronary lesions (angiographic 30%-80% stenosis). dPR was calculated using individual pressure waveforms and dedicated software. Clinical, angiographic and hemodynamic variables were compared between patients with concordant and discordant FFR and dPR values. Results: Median age was 65 (IQR:59–73) years and 70% were male. Hemodynamically significant lesions, as defined by FFR ≤ 0.80, and dPR ≤ 0.89, were identified in 29.6% and 30.3% of cases, respectively. Overall, FFR and dPR values were discordant in 22.1% patients (17.4% of the vessels). Discordance was related to FFR+/dPR- and FFR-/dPR + in 11.8% and 10.3% of patients, respectively.In case of FFR-dPR discordance, a higher prevalence of left anterior descending arteries lesions was observed (70.5% vs. 53.1%, p < 0.001) and mean values of both FFR and dPR were significantly lower (FFR 0.81 ± 0.05 vs 0.85 ± 0.08, p < 0.001, and dPR 0.89 ± 0.04 vs 0.92 ± 0.08,p < 0.001) as compared to vessels with FFR and dPR concordance. Following multivariable adjustment, dPR delta (defined as the absolute difference between measured dPR to the cut-off value of 0.89) turned out to be the only independent predictor of discordance (OR = 0.74, 95% CI 0.68–0.79, p < 0.001). Conclusion: Our study suggests that FFR-to-dPR discordance occurs in approximately one-fifth of patients. Absolute dPR delta appears to be the only independent predictor of discordance. |
| first_indexed | 2024-03-12T17:11:45Z |
| format | Article |
| id | doaj.art-dd6b68f0e2064e2e85d536a9cdca1ac8 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-03-12T17:11:45Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-dd6b68f0e2064e2e85d536a9cdca1ac82023-08-06T04:37:47ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672023-08-0147101217Predictors of discordance between fractional flow reserve (FFR) and diastolic pressure ratio (dPR) in intermediate coronary lesionsAlessandra Scoccia0Tara Neleman1Annemieke C. Ziedses des Plantes2Frederik T.W. Groenland3Jurgen M R Ligthart4Wijnand K. den Dekker5Roberto Diletti6Jeroen Wilschut7Rutger Jan Nuis8Felix Zijlstra9Eric Boersma10Nicolas M Van Mieghem11Joost Daemen12Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the NetherlandsDepartment of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the NetherlandsDepartment of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the NetherlandsDepartment of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the NetherlandsDepartment of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the NetherlandsDepartment of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the NetherlandsDepartment of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the NetherlandsDepartment of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the NetherlandsDepartment of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the NetherlandsDepartment of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the NetherlandsDepartment of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the NetherlandsDepartment of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the NetherlandsCorresponding author at: Department of Cardiology, room Rg-628, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.; Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the NetherlandsBackground: Recently, non-hyperemic pressure ratios (NHPRs) have been validated as a reliable alternative to fractional flow reserve (FFR). However, a discordance between FFR and NHPRs is observed in 20–25% of cases. The aim of this study is to evaluate predictors of discordance between FFR and diastolic Pressure ratio (dPR). Methods: PREDICT is a retrospective, single center, investigator-initiated study including 813 patients (1092vessels) who underwent FFR assessment of intermediate coronary lesions (angiographic 30%-80% stenosis). dPR was calculated using individual pressure waveforms and dedicated software. Clinical, angiographic and hemodynamic variables were compared between patients with concordant and discordant FFR and dPR values. Results: Median age was 65 (IQR:59–73) years and 70% were male. Hemodynamically significant lesions, as defined by FFR ≤ 0.80, and dPR ≤ 0.89, were identified in 29.6% and 30.3% of cases, respectively. Overall, FFR and dPR values were discordant in 22.1% patients (17.4% of the vessels). Discordance was related to FFR+/dPR- and FFR-/dPR + in 11.8% and 10.3% of patients, respectively.In case of FFR-dPR discordance, a higher prevalence of left anterior descending arteries lesions was observed (70.5% vs. 53.1%, p < 0.001) and mean values of both FFR and dPR were significantly lower (FFR 0.81 ± 0.05 vs 0.85 ± 0.08, p < 0.001, and dPR 0.89 ± 0.04 vs 0.92 ± 0.08,p < 0.001) as compared to vessels with FFR and dPR concordance. Following multivariable adjustment, dPR delta (defined as the absolute difference between measured dPR to the cut-off value of 0.89) turned out to be the only independent predictor of discordance (OR = 0.74, 95% CI 0.68–0.79, p < 0.001). Conclusion: Our study suggests that FFR-to-dPR discordance occurs in approximately one-fifth of patients. Absolute dPR delta appears to be the only independent predictor of discordance.http://www.sciencedirect.com/science/article/pii/S2352906723000489Coronary physiologydiastolic Pressure ratioFractional flow reserveNon-hyperemic pressure ratioDiscordance in coronary physiology |
| spellingShingle | Alessandra Scoccia Tara Neleman Annemieke C. Ziedses des Plantes Frederik T.W. Groenland Jurgen M R Ligthart Wijnand K. den Dekker Roberto Diletti Jeroen Wilschut Rutger Jan Nuis Felix Zijlstra Eric Boersma Nicolas M Van Mieghem Joost Daemen Predictors of discordance between fractional flow reserve (FFR) and diastolic pressure ratio (dPR) in intermediate coronary lesions International Journal of Cardiology: Heart & Vasculature Coronary physiology diastolic Pressure ratio Fractional flow reserve Non-hyperemic pressure ratio Discordance in coronary physiology |
| title | Predictors of discordance between fractional flow reserve (FFR) and diastolic pressure ratio (dPR) in intermediate coronary lesions |
| title_full | Predictors of discordance between fractional flow reserve (FFR) and diastolic pressure ratio (dPR) in intermediate coronary lesions |
| title_fullStr | Predictors of discordance between fractional flow reserve (FFR) and diastolic pressure ratio (dPR) in intermediate coronary lesions |
| title_full_unstemmed | Predictors of discordance between fractional flow reserve (FFR) and diastolic pressure ratio (dPR) in intermediate coronary lesions |
| title_short | Predictors of discordance between fractional flow reserve (FFR) and diastolic pressure ratio (dPR) in intermediate coronary lesions |
| title_sort | predictors of discordance between fractional flow reserve ffr and diastolic pressure ratio dpr in intermediate coronary lesions |
| topic | Coronary physiology diastolic Pressure ratio Fractional flow reserve Non-hyperemic pressure ratio Discordance in coronary physiology |
| url | http://www.sciencedirect.com/science/article/pii/S2352906723000489 |
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