Table 6

Considerations for the Omission of Right Atrial Pressure From the Calculation of FFR

ConsiderationForAgainst
Physiological reasoning regarding FFRRight atrial pressure is assumed negligible relative to aortic pressure (77)Right atrial pressure values vary individually amongst patients
Right atrial pressure is a key component of the original FFRmyo equation that was validated against ischemia testing (1,19)
Omission of right atrial pressure systematically underestimates FFRmyo values (23)
Revascularization decision makingFAME and FAME 2 clinical outcome trials omitted right atrial pressure from the FFR calculation
Initially deferred stenoses do not cross the FFR 0.75 threshold when right atrial pressure is subsequently included in the FFR calculation (24)
FAME and FAME 2 clinical outcome trials are not representative of intermediate disease clinical populations (22)
Approximately 10% of initially deferred stenoses cross the FFR 0.80 threshold when right atrial pressure is subsequently included in the FFR calculation (24)

Abbreviations as in Tables 3 and 5.