Fluid-filled versus sensor-tipped pressure guidewires for FFR and P d /P a measurement; PW-COMPARE study.

Autor: Eerdekens R; Heart Center, Catharina Hospital, Eindhoven, the Netherlands., Tonino PAL; Heart Center, Catharina Hospital, Eindhoven, the Netherlands., Zimmermann FM; Heart Center, Catharina Hospital, Eindhoven, the Netherlands., Teeuwen K; Heart Center, Catharina Hospital, Eindhoven, the Netherlands., Vlaar PJ; Heart Center, Catharina Hospital, Eindhoven, the Netherlands., de Waard GA; Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands., van Royen N; Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands., van Nunen LX; Heart Center, Catharina Hospital, Eindhoven, the Netherlands; Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: lokien.vannunen@radboudumc.nl.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2024 Jul 01; Vol. 406, pp. 131998. Date of Electronic Publication: 2024 Mar 28.
DOI: 10.1016/j.ijcard.2024.131998
Abstrakt: Background: Fluid-filled pressure guidewires are unaffected by the previously inevitable hydrostatic pressure gradient (HPG). This study aimed to compare simultaneous pressure measurements with fluid-filled and sensor-tipped pressure guidewires.
Methods: Fifty patients underwent fractional flow reserve (FFR) and P d /P a measurement with a fluid-filled and a sensor-tipped pressure guidewire simultaneously. To assess maneuverability, patients were randomized with respect to which pressure guidewire was used to cross the lesion first. Lateral fluoroscopy was used to estimate height difference between catheter tip and distal wire position (and thus HPG). Agreement between pressure measurements was studied.
Results: Measurements were performed in LM (4% (n = 2)), LAD (44% (n = 22)), LCX (26% (n = 13)), and RCA (26% (n = 13)). Simultaneous pressure measurements showed excellent agreement (mean FFR difference - 0.01 ± 0.03 (r = 0.959, p < 0.001), mean P d /P a difference - 0.01 ± 0.04 (r = 0.929, p < 0.001)). FFR was ≤0.80 in 42.6% (n = 20) with fluid-filled FFR measurements versus 46.8% (n = 22) by sensor-tipped FFR measurements. Mean height difference was 15 ± 34 mm, and strongly dependent on the coronary artery (LAD 45 ± 10 mm, LCX -23 ± 16 mm, RCA -13 ± 17 mm). There was a strong correlation between height difference and difference in pressure ratios between sensor-tipped and fluid-filled pressure guidewires (FFR r = -0.850, p < 0.001; P d /P a r = -0.641, p < 0.001). Largest FFR differences were present in the LAD (-0.04 ± 0.02). After HPG correction, mean difference between HPG-corrected sensor-tipped FFR and fluid-filled FFR was 0.00 ± 0.02, mean P d /P a difference was 0.01 ± 0.03.
Conclusions: This study shows excellent overall correlation between FFR and P d /P a measurements with both pressure guidewires. Differences measured with fluid-filled and sensor-tipped pressure guidewires are vessel-specific and attributable to hydrostatic pressure gradients (NCT04802681).
Competing Interests: Declaration of competing interest PT received research grants from Cavis Technologies AB, Biosensors, OpSens Medical and lecture fees from Medtronic. NvR received personal fees from Abbott, Rainmed, Microport and Bayer and received research grants from Philips, Biotronik, Abbott, and Medtronic. EH is a former employee of Cavis Technologies AB. The other authors have no conflicts of interest to declare.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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