The effects of cardiac structure, valvular regurgitation, and left ventricular diastolic dysfunction on the diagnostic accuracy of Murray law–based quantitative flow ratio

ObjectiveThe study aimed to investigate the diagnostic accuracy of Murray law–based quantitative flow ratio (μQFR) from a single angiographic view in patients with abnormal cardiac structure, left ventricular diastolic dysfunction, and valvular regurgitation.BackgroundμQFR is a novel fluid dynamics...

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Main Authors: Junqing Yang, Yuming Huang, Xiaoshan Li, Qianjun Jia, Huiliang Deng, Nianjin Xie, Meiping Huang, Hongwen Fei
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-05-01
Series:Frontiers in Cardiovascular Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2023.1134623/full
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author Junqing Yang
Yuming Huang
Xiaoshan Li
Xiaoshan Li
Qianjun Jia
Huiliang Deng
Nianjin Xie
Meiping Huang
Hongwen Fei
Hongwen Fei
author_facet Junqing Yang
Yuming Huang
Xiaoshan Li
Xiaoshan Li
Qianjun Jia
Huiliang Deng
Nianjin Xie
Meiping Huang
Hongwen Fei
Hongwen Fei
author_sort Junqing Yang
collection DOAJ
description ObjectiveThe study aimed to investigate the diagnostic accuracy of Murray law–based quantitative flow ratio (μQFR) from a single angiographic view in patients with abnormal cardiac structure, left ventricular diastolic dysfunction, and valvular regurgitation.BackgroundμQFR is a novel fluid dynamics method for deriving fractional flow reserve (FFR). In addition, current studies of μQFR mainly analyzed patients with normal cardiac structure and function. The accuracy of μQFR when patients had abnormal cardiac structure, left ventricular diastolic dysfunction, and valvular regurgitation has not been clear.MethodsThis study retrospectively analyzed 261 patients with 286 vessels that underwent both FFR and μQFR prior to intervention. The cardiac structure and function were measured using echocardiography. Pressure wire–derived FFR ≤0.80 was defined as hemodynamically significant coronary stenosis.ResultsμQFR had a moderate correlation with FFR (r = 0.73, p < 0.001), and the Bland–Altman plot presented no difference between the μQFR and FFR (0.006 ± 0.075, p = 0.192). With FFR as the standard, the diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of μQFR were 94.06% (90.65–96.50), 82.56% (72.87–89.90), 99.00% (96.44–99.88), 97.26 (89.91–99.30), and 92.96% (89.29–95.44), respectively. The concordance of μQFR/FFR was not associated with abnormal cardiac structure, valvular regurgitation (aortic valve, mitral valve, and tricuspid valve), and left ventricular diastolic function. Coronary hemodynamics showed no difference between normality and abnormality of cardiac structure and left ventricular diastolic function. Coronary hemodynamics demonstrated no difference among valvular regurgitation (none, mild, moderate, or severe).ConclusionμQFR showed an excellent agreement with FFR. The effect of abnormal cardiac structure, valvular regurgitation, and left ventricular diastolic function did not correlate with the diagnostic accuracy of μQFR. Coronary hemodynamics showed no difference in patients with abnormal cardiac structure, valvular regurgitation, and left ventricular diastolic function.
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spelling doaj.art-e31e313f63814d0780349dd589f20e912023-05-24T04:57:15ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-05-011010.3389/fcvm.2023.11346231134623The effects of cardiac structure, valvular regurgitation, and left ventricular diastolic dysfunction on the diagnostic accuracy of Murray law–based quantitative flow ratioJunqing Yang0Yuming Huang1Xiaoshan Li2Xiaoshan Li3Qianjun Jia4Huiliang Deng5Nianjin Xie6Meiping Huang7Hongwen Fei8Hongwen Fei9Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Catheterization Lab, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaGuangdong Medical University, Zhanjiang, ChinaGuangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Catheterization Lab, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Catheterization Lab, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaDepartment of Catheterization Lab, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaGuangdong Medical University, Zhanjiang, ChinaGuangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, ChinaObjectiveThe study aimed to investigate the diagnostic accuracy of Murray law–based quantitative flow ratio (μQFR) from a single angiographic view in patients with abnormal cardiac structure, left ventricular diastolic dysfunction, and valvular regurgitation.BackgroundμQFR is a novel fluid dynamics method for deriving fractional flow reserve (FFR). In addition, current studies of μQFR mainly analyzed patients with normal cardiac structure and function. The accuracy of μQFR when patients had abnormal cardiac structure, left ventricular diastolic dysfunction, and valvular regurgitation has not been clear.MethodsThis study retrospectively analyzed 261 patients with 286 vessels that underwent both FFR and μQFR prior to intervention. The cardiac structure and function were measured using echocardiography. Pressure wire–derived FFR ≤0.80 was defined as hemodynamically significant coronary stenosis.ResultsμQFR had a moderate correlation with FFR (r = 0.73, p < 0.001), and the Bland–Altman plot presented no difference between the μQFR and FFR (0.006 ± 0.075, p = 0.192). With FFR as the standard, the diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of μQFR were 94.06% (90.65–96.50), 82.56% (72.87–89.90), 99.00% (96.44–99.88), 97.26 (89.91–99.30), and 92.96% (89.29–95.44), respectively. The concordance of μQFR/FFR was not associated with abnormal cardiac structure, valvular regurgitation (aortic valve, mitral valve, and tricuspid valve), and left ventricular diastolic function. Coronary hemodynamics showed no difference between normality and abnormality of cardiac structure and left ventricular diastolic function. Coronary hemodynamics demonstrated no difference among valvular regurgitation (none, mild, moderate, or severe).ConclusionμQFR showed an excellent agreement with FFR. The effect of abnormal cardiac structure, valvular regurgitation, and left ventricular diastolic function did not correlate with the diagnostic accuracy of μQFR. Coronary hemodynamics showed no difference in patients with abnormal cardiac structure, valvular regurgitation, and left ventricular diastolic function.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1134623/fullcoronary hemodynamicscoronary heart diseaseechocardiographyfractional flow reservequantitative flow ratio
spellingShingle Junqing Yang
Yuming Huang
Xiaoshan Li
Xiaoshan Li
Qianjun Jia
Huiliang Deng
Nianjin Xie
Meiping Huang
Hongwen Fei
Hongwen Fei
The effects of cardiac structure, valvular regurgitation, and left ventricular diastolic dysfunction on the diagnostic accuracy of Murray law–based quantitative flow ratio
Frontiers in Cardiovascular Medicine
coronary hemodynamics
coronary heart disease
echocardiography
fractional flow reserve
quantitative flow ratio
title The effects of cardiac structure, valvular regurgitation, and left ventricular diastolic dysfunction on the diagnostic accuracy of Murray law–based quantitative flow ratio
title_full The effects of cardiac structure, valvular regurgitation, and left ventricular diastolic dysfunction on the diagnostic accuracy of Murray law–based quantitative flow ratio
title_fullStr The effects of cardiac structure, valvular regurgitation, and left ventricular diastolic dysfunction on the diagnostic accuracy of Murray law–based quantitative flow ratio
title_full_unstemmed The effects of cardiac structure, valvular regurgitation, and left ventricular diastolic dysfunction on the diagnostic accuracy of Murray law–based quantitative flow ratio
title_short The effects of cardiac structure, valvular regurgitation, and left ventricular diastolic dysfunction on the diagnostic accuracy of Murray law–based quantitative flow ratio
title_sort effects of cardiac structure valvular regurgitation and left ventricular diastolic dysfunction on the diagnostic accuracy of murray law based quantitative flow ratio
topic coronary hemodynamics
coronary heart disease
echocardiography
fractional flow reserve
quantitative flow ratio
url https://www.frontiersin.org/articles/10.3389/fcvm.2023.1134623/full
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