eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
Current issue Archive Manuscripts accepted About the journal Editorial board Abstracting and indexing Subscription Contact Instructions for authors Publication charge Ethical standards and procedures
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
3/2019
vol. 15
 
Share:
Share:
abstract:
Original paper

Quantitative flow ratio and fractional flow reserve mismatch – clinical and biochemical predictors of measurement discrepancy

Martyna Zaleska
1
,
Lukasz Koltowski
1
,
Jakub Maksym
1
,
Aleksandra K. Chabior
1
,
Aleksandra Pohadajło
1
,
Mateusz Soliński
2
,
Mariusz Tomaniak
1
,
Grzegorz Opolski
1
,
Janusz Kochman
1

  1. First Chair and Department of Cardiology, Warsaw Medical University, Warsaw, Poland
  2. Faculty of Physics, Warsaw University of Technology, Warsaw, Poland
Adv Interv Cardiol 2019; 15, 3 (57): 301–307
Online publish date: 2019/09/18
View full text Get citation
 
Introduction
Fractional flow reserve (FFR) is the gold standard for functional assessment of intermediate lesions. However, assessing a stenosis with pressure wire prolongs the procedure, increases costs and carries a risk of procedure-related adverse events. Quantitative flow ratio (QFR) is a wire-free method for detection of significant ischemia based on 3D reconstruction of angiographic images and TIMI frame count.

Aim
To evaluate the influence of laboratory and clinical variables on QFR-FFR mismatch.

Material and methods
We retrospectively computed QFR (Medis Suite XA/QAngio XA 3D/QFR, Medis/Netherlands) in suitable cases with corresponding FFR (PressureWire, Abbott, US). Uni-/multivariate analysis was performed to identify clinical and biochemical predictors of QFR-FFR mismatch.

Results
Two hundred six lesions (196 patients, 76% male, mean age: 66.4 ±10.1 years) were included. Chronic kidney disease (CKD) and insulin-treated diabetes mellitus (ITDM) were associated with significantly larger differences between QFR and FFR values (–0.062 ±0.031 vs. –0.025 ±0.068; p = 0.027 and –0.059 ±0.07 vs. –0.027 ±0.074; p = 0.039; respectively). CKD was associated with a decrease of diagnostic efficiency (AUC = 0.67, 95% CI: 0.46–0.88 vs. AUC = 0.89, 95% CI: 0.84–0.94, p = 0.05). For biochemical variables only weak Spearman correlations were identified for hemoglobin concentration (r = –0.18) and hematocrit levels (r = –0.18).

Conclusions
CKD may impair the QFR diagnostic accuracy. Larger, prospective studies are needed to further explore this potential relationship.

keywords:

chronic kidney disease, computational fluid dynamics, hematocrit, insulin treated diabetes mellitus, hemoglobin concentration

Quick links
© 2024 Termedia Sp. z o.o.
Developed by Bentus.