The effect of hydrostatic pressure on invasive coronary pressure measurements: Comparison with [ 15 O]H 2 O-positron emission tomography flow data.

Autor: Wilgenhof A; Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium.; Department of Cardiology, Amsterdam Cardiovascular Sciences Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.; Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy., Jukema RA; Department of Cardiology, Amsterdam Cardiovascular Sciences Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands., Driessen RS; Department of Cardiology, Amsterdam Cardiovascular Sciences Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands., Danad I; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands., Raijmakers PG; Department of Cardiology, Amsterdam Cardiovascular Sciences Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.; Radiology, Nuclear Medicine & PET Research, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands., van Royen N; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands., van Nunen LX; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands., Collet C; Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium., de Waard GA; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands., Knaapen P; Department of Cardiology, Amsterdam Cardiovascular Sciences Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2024 Nov; Vol. 104 (5), pp. 980-989. Date of Electronic Publication: 2024 Sep 11.
DOI: 10.1002/ccd.31215
Abstrakt: Background: Fractional flow reserve (FFR) has emerged as the invasive gold standard for assessing vessel-specific ischemia. However, FFR measurements are influenced by the hydrostatic effect, which might adversely impact the assessment of ischemia.
Aims: This study aimed to investigate the impact of hydrostatic pressure on FFR measurements by correcting for the height and comparing FFR with [ 15 O]H 2 O positron emission tomography (PET)-derived relative flow reserve (RFR).
Methods: The 206 patients were included in this analysis. Patients underwent coronary computed tomography angiography (CCTA), [ 15 O]H 2 O PET, and invasive coronary angiography with routine FFR in every epicardial artery. Height differences between the aortic guiding catheter and distal pressure sensor were quantified on CCTA images. An FFR ≤ 0.80 was considered significant.
Results: The study found a reclassification in 7% of the coronary arteries. Notably, 11% of left anterior descending (LAD) arteries were reclassified from hemodynamically significant to nonsignificant. Conversely, 6% of left circumflex (Cx) arteries were reclassified from nonsignificant to significant. After correcting for the hydrostatic pressure effect, the correlation between FFR and PET-derived RFR increased significantly from r = 0.720 to r = 0.786 (p = 0.009). The average magnitude of correction was +0.05 FFR units in the LAD, -0.03 in the Cx, and -0.02 in the right coronary artery.
Conclusion: Hydrostatic pressure has a small but clinically relevant influence on FFR measurements obtained with a pressure wire. Correcting for this hydrostatic error significantly enhances the correlation between FFR and PET-derived RFR.
(© 2024 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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