Predictive factors of discordance between the instantaneous wave-free ratio and fractional flow reserve

François Dérimay, Nils P. Johnson, Frederik M. Zimmermann, Julien Adjedj, Nils Witt, Barry Hennigan, Bon Kwon Koo, Emanuele Barbato, Giovanni Esposito, Bruno Trimarco, Gilles Rioufol, Seung Jung Park, Sérgio Bravo Baptista, George S. Chrysant, Antonio Maria Leone, Allen Jeremias, Colin Berry, Bernard De Bruyne, Keith G. Oldroyd, Nico H.J. Pijls & 1 andere William F. Fearon

Onderzoeksoutput: Bijdrage aan tijdschriftTijdschriftartikelAcademicpeer review

2 Citaties (Scopus)

Uittreksel

Objectives: To identify clinical, angiographic and hemodynamic predictors of discordance between instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR). Background: The iFR was found to be non-inferior to the gold-standard FFR for guiding coronary revascularization, although it is discordant with FFR in 20% of cases. A better understanding of the causes of discordance may enhance application of these indices. Methods: Both FFR and iFR were measured in the prospective multicenter CONTRAST study. Clinical, angiographic and hemodynamic variables were compared between patients with concordant values of FFR and iFR (cutoff ≤0.80 and ≤0.89, respectively). Results: Out of the 587 patients included, in 466 patients (79.4%) FFR and iFR agreed: both negative, n = 244 (41.6%), or positive, n = 222 (37.8%). Compared with FFR, iFR was negative discordant (FFR+/iFR-) in 69 (11.8%) patients and positive discordant (FFR-/iFR+) in 52 (8.9%) patients. On multivariate regression, stenosis location (left main or proximal left anterior descending) (OR: 3.30[1.68;6.47]), more severe stenosis (OR: 1.77[1.35;2.30]), younger age (OR: 0.93[0.90;0.97]), and slower heart rate (OR: 0.59[0.42;0.75]) were predictors of a negative discordant iFR. Absence of a beta-blocker (OR: 0.41[0.22;0.78]), older age (OR: 1.04[1.00;1.07]), and less severe stenosis (OR: 0.69[0.53;0.89]) were predictors of a positive discordant iFR. Conclusions: During iFR acquisition, stenosis location, stenosis degree, heart rate, age and use of beta blockers influence concordance with FFR and should be taken into account when interpreting iFR.

TaalEngels
Pagina's356-363
TijdschriftCatheterization and Cardiovascular Interventions
Volume94
Nummer van het tijdschrift3
DOI's
StatusGepubliceerd - sep 2019

Vingerafdruk

Pathologic Constriction
Heart Rate
Hemodynamics
Gold
Multicenter Studies

Trefwoorden

    Citeer dit

    Dérimay, F., Johnson, N. P., Zimmermann, F. M., Adjedj, J., Witt, N., Hennigan, B., ... Fearon, W. F. (2019). Predictive factors of discordance between the instantaneous wave-free ratio and fractional flow reserve. Catheterization and Cardiovascular Interventions, 94(3), 356-363. DOI: 10.1002/ccd.28116
    Dérimay, François ; Johnson, Nils P. ; Zimmermann, Frederik M. ; Adjedj, Julien ; Witt, Nils ; Hennigan, Barry ; Koo, Bon Kwon ; Barbato, Emanuele ; Esposito, Giovanni ; Trimarco, Bruno ; Rioufol, Gilles ; Park, Seung Jung ; Baptista, Sérgio Bravo ; Chrysant, George S. ; Leone, Antonio Maria ; Jeremias, Allen ; Berry, Colin ; De Bruyne, Bernard ; Oldroyd, Keith G. ; Pijls, Nico H.J. ; Fearon, William F./ Predictive factors of discordance between the instantaneous wave-free ratio and fractional flow reserve. In: Catheterization and Cardiovascular Interventions. 2019 ; Vol. 94, Nr. 3. blz. 356-363
    @article{ee2b99f90f78454988e07b42bc157b0e,
    title = "Predictive factors of discordance between the instantaneous wave-free ratio and fractional flow reserve",
    abstract = "Objectives: To identify clinical, angiographic and hemodynamic predictors of discordance between instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR). Background: The iFR was found to be non-inferior to the gold-standard FFR for guiding coronary revascularization, although it is discordant with FFR in 20{\%} of cases. A better understanding of the causes of discordance may enhance application of these indices. Methods: Both FFR and iFR were measured in the prospective multicenter CONTRAST study. Clinical, angiographic and hemodynamic variables were compared between patients with concordant values of FFR and iFR (cutoff ≤0.80 and ≤0.89, respectively). Results: Out of the 587 patients included, in 466 patients (79.4{\%}) FFR and iFR agreed: both negative, n = 244 (41.6{\%}), or positive, n = 222 (37.8{\%}). Compared with FFR, iFR was negative discordant (FFR+/iFR-) in 69 (11.8{\%}) patients and positive discordant (FFR-/iFR+) in 52 (8.9{\%}) patients. On multivariate regression, stenosis location (left main or proximal left anterior descending) (OR: 3.30[1.68;6.47]), more severe stenosis (OR: 1.77[1.35;2.30]), younger age (OR: 0.93[0.90;0.97]), and slower heart rate (OR: 0.59[0.42;0.75]) were predictors of a negative discordant iFR. Absence of a beta-blocker (OR: 0.41[0.22;0.78]), older age (OR: 1.04[1.00;1.07]), and less severe stenosis (OR: 0.69[0.53;0.89]) were predictors of a positive discordant iFR. Conclusions: During iFR acquisition, stenosis location, stenosis degree, heart rate, age and use of beta blockers influence concordance with FFR and should be taken into account when interpreting iFR.",
    keywords = "coronary physiology, fractional flow reserve, instantaneous wave-free ratio",
    author = "Fran{\cc}ois D{\'e}rimay and Johnson, {Nils P.} and Zimmermann, {Frederik M.} and Julien Adjedj and Nils Witt and Barry Hennigan and Koo, {Bon Kwon} and Emanuele Barbato and Giovanni Esposito and Bruno Trimarco and Gilles Rioufol and Park, {Seung Jung} and Baptista, {S{\'e}rgio Bravo} and Chrysant, {George S.} and Leone, {Antonio Maria} and Allen Jeremias and Colin Berry and {De Bruyne}, Bernard and Oldroyd, {Keith G.} and Pijls, {Nico H.J.} and Fearon, {William F.}",
    year = "2019",
    month = "9",
    doi = "10.1002/ccd.28116",
    language = "English",
    volume = "94",
    pages = "356--363",
    journal = "Catheterization and Cardiovascular Interventions",
    issn = "1522-1946",
    publisher = "Wiley-Liss Inc.",
    number = "3",

    }

    Dérimay, F, Johnson, NP, Zimmermann, FM, Adjedj, J, Witt, N, Hennigan, B, Koo, BK, Barbato, E, Esposito, G, Trimarco, B, Rioufol, G, Park, SJ, Baptista, SB, Chrysant, GS, Leone, AM, Jeremias, A, Berry, C, De Bruyne, B, Oldroyd, KG, Pijls, NHJ & Fearon, WF 2019, 'Predictive factors of discordance between the instantaneous wave-free ratio and fractional flow reserve' Catheterization and Cardiovascular Interventions, vol. 94, nr. 3, blz. 356-363. DOI: 10.1002/ccd.28116

    Predictive factors of discordance between the instantaneous wave-free ratio and fractional flow reserve. / Dérimay, François; Johnson, Nils P.; Zimmermann, Frederik M.; Adjedj, Julien; Witt, Nils; Hennigan, Barry; Koo, Bon Kwon; Barbato, Emanuele; Esposito, Giovanni; Trimarco, Bruno; Rioufol, Gilles; Park, Seung Jung; Baptista, Sérgio Bravo; Chrysant, George S.; Leone, Antonio Maria; Jeremias, Allen; Berry, Colin; De Bruyne, Bernard; Oldroyd, Keith G.; Pijls, Nico H.J.; Fearon, William F. (Corresponding author).

    In: Catheterization and Cardiovascular Interventions, Vol. 94, Nr. 3, 09.2019, blz. 356-363.

    Onderzoeksoutput: Bijdrage aan tijdschriftTijdschriftartikelAcademicpeer review

    TY - JOUR

    T1 - Predictive factors of discordance between the instantaneous wave-free ratio and fractional flow reserve

    AU - Dérimay,François

    AU - Johnson,Nils P.

    AU - Zimmermann,Frederik M.

    AU - Adjedj,Julien

    AU - Witt,Nils

    AU - Hennigan,Barry

    AU - Koo,Bon Kwon

    AU - Barbato,Emanuele

    AU - Esposito,Giovanni

    AU - Trimarco,Bruno

    AU - Rioufol,Gilles

    AU - Park,Seung Jung

    AU - Baptista,Sérgio Bravo

    AU - Chrysant,George S.

    AU - Leone,Antonio Maria

    AU - Jeremias,Allen

    AU - Berry,Colin

    AU - De Bruyne,Bernard

    AU - Oldroyd,Keith G.

    AU - Pijls,Nico H.J.

    AU - Fearon,William F.

    PY - 2019/9

    Y1 - 2019/9

    N2 - Objectives: To identify clinical, angiographic and hemodynamic predictors of discordance between instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR). Background: The iFR was found to be non-inferior to the gold-standard FFR for guiding coronary revascularization, although it is discordant with FFR in 20% of cases. A better understanding of the causes of discordance may enhance application of these indices. Methods: Both FFR and iFR were measured in the prospective multicenter CONTRAST study. Clinical, angiographic and hemodynamic variables were compared between patients with concordant values of FFR and iFR (cutoff ≤0.80 and ≤0.89, respectively). Results: Out of the 587 patients included, in 466 patients (79.4%) FFR and iFR agreed: both negative, n = 244 (41.6%), or positive, n = 222 (37.8%). Compared with FFR, iFR was negative discordant (FFR+/iFR-) in 69 (11.8%) patients and positive discordant (FFR-/iFR+) in 52 (8.9%) patients. On multivariate regression, stenosis location (left main or proximal left anterior descending) (OR: 3.30[1.68;6.47]), more severe stenosis (OR: 1.77[1.35;2.30]), younger age (OR: 0.93[0.90;0.97]), and slower heart rate (OR: 0.59[0.42;0.75]) were predictors of a negative discordant iFR. Absence of a beta-blocker (OR: 0.41[0.22;0.78]), older age (OR: 1.04[1.00;1.07]), and less severe stenosis (OR: 0.69[0.53;0.89]) were predictors of a positive discordant iFR. Conclusions: During iFR acquisition, stenosis location, stenosis degree, heart rate, age and use of beta blockers influence concordance with FFR and should be taken into account when interpreting iFR.

    AB - Objectives: To identify clinical, angiographic and hemodynamic predictors of discordance between instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR). Background: The iFR was found to be non-inferior to the gold-standard FFR for guiding coronary revascularization, although it is discordant with FFR in 20% of cases. A better understanding of the causes of discordance may enhance application of these indices. Methods: Both FFR and iFR were measured in the prospective multicenter CONTRAST study. Clinical, angiographic and hemodynamic variables were compared between patients with concordant values of FFR and iFR (cutoff ≤0.80 and ≤0.89, respectively). Results: Out of the 587 patients included, in 466 patients (79.4%) FFR and iFR agreed: both negative, n = 244 (41.6%), or positive, n = 222 (37.8%). Compared with FFR, iFR was negative discordant (FFR+/iFR-) in 69 (11.8%) patients and positive discordant (FFR-/iFR+) in 52 (8.9%) patients. On multivariate regression, stenosis location (left main or proximal left anterior descending) (OR: 3.30[1.68;6.47]), more severe stenosis (OR: 1.77[1.35;2.30]), younger age (OR: 0.93[0.90;0.97]), and slower heart rate (OR: 0.59[0.42;0.75]) were predictors of a negative discordant iFR. Absence of a beta-blocker (OR: 0.41[0.22;0.78]), older age (OR: 1.04[1.00;1.07]), and less severe stenosis (OR: 0.69[0.53;0.89]) were predictors of a positive discordant iFR. Conclusions: During iFR acquisition, stenosis location, stenosis degree, heart rate, age and use of beta blockers influence concordance with FFR and should be taken into account when interpreting iFR.

    KW - coronary physiology

    KW - fractional flow reserve

    KW - instantaneous wave-free ratio

    UR - http://www.scopus.com/inward/record.url?scp=85061063889&partnerID=8YFLogxK

    U2 - 10.1002/ccd.28116

    DO - 10.1002/ccd.28116

    M3 - Article

    VL - 94

    SP - 356

    EP - 363

    JO - Catheterization and Cardiovascular Interventions

    T2 - Catheterization and Cardiovascular Interventions

    JF - Catheterization and Cardiovascular Interventions

    SN - 1522-1946

    IS - 3

    ER -

    Dérimay F, Johnson NP, Zimmermann FM, Adjedj J, Witt N, Hennigan B et al. Predictive factors of discordance between the instantaneous wave-free ratio and fractional flow reserve. Catheterization and Cardiovascular Interventions. 2019 sep;94(3):356-363. Beschikbaar vanaf, DOI: 10.1002/ccd.28116