Author + information
- Yoshinori Kanno,
- Masahiro Hoshino,
- Akinori Sugano,
- Yoshihisa Kanaji,
- Masao Yamaguchi,
- Yohei Sumino,
- Hiroaki Ohya,
- Masahiro Hada,
- Hidenori Hirano,
- Haruhito Yuki,
- Tomoki Horie,
- Taishi Yonetsu and
- Tsunekazu Kakuta
Measurement of the contrast-flow quantitative flow ratio (cQFR) is a novel method for rapid computational estimation of fractional flow reserve (FFR). Discordance between FFR and cQFR has not been completely characterized.
We performed a post-hocanalysis of 504 vessels with angiographically intermediate stenosis in 504 patients who underwent measurement of FFR, coronary flow reserve (CFR), the index of microcirculatory resistance (IMR), and Duke jeopardy score.
In total, 396 (78.6%) and 108 (21.4%) lesions showed concordant and discordant FFR and cQFR functional classifications, respectively. Among lesions with a reducedFFR(FFR+), those with a preservedcQFR (cQFR-) showed significantly lower IMR, shorter Tmn, shorter lesion length (all, P<0.01), and similar CFR and Duke Jeopardy scores compared with reduced cQFR(cQFR+) lesions. Furthermore, lesions with FFR+and cQFR-had significantly lower IMR and shorter Tmn compared with lesions showing FFR-and cQFR+. Of note, in cQFR+ lesions, higher IMR lesions were associated with decreased diagnostic accuracy (high-IMR: 63.0% and low-IMR 75.8%, P<0.01). In contrast, in cQFR-lesions, lower IMR lesions was associated with decreased diagnostic accuracy (high-IMR group; 96.8% and low-IMR group; 80.0%, P<0.01). Notably, wefound 36 (7.1%) lesions, which the functional assessment jumped beyond the gray zone (0.75-0.80) into the opposite decision-making zone between FFR-guided and cQFR-guided decision-making.
FFR-with cQFR+ is associated with increased microvascular resistance, and FFR+ with cQFR-showed preservation of microvascular function with high coronary flow. Microvascular function affected diagnostic performance of cQFR in relation to functional stenosis significance.
Poster Hall, Hall F
Saturday, March 16, 2019, 3:45 p.m.-4:30 p.m.
Session Title: Interventional Cardiology: IVUS and Intravascular Physiology 2
Abstract Category: 23. Interventional Cardiology: IVUS and Intravascular Physiology
Presentation Number: 1153-034
- 2019 American College of Cardiology Foundation