Referral of patients for fractional flow reserve using quantitative flow ratio
| Autor: | Arthur J.H.A. Scholte, Alexander R. van Rosendael, Gerhard Koning, Martin J. Schalij, Jeff M. Smit, Bart Mertens, Victoria Delgado, Johan H. C. Reiber, Jeroen J. Bax, Mohammed El Mahdiui, J. Wouter Jukema |
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| Rok vydání: | 2018 |
| Předmět: |
Coronary angiography
Male medicine.medical_specialty Referral medicine.medical_treatment Fractional flow reserve computational fluid dynamics 030204 cardiovascular system & hematology Coronary Angiography Coronary artery disease 03 medical and health sciences 0302 clinical medicine Imaging Three-Dimensional Risk Factors Internal medicine medicine Humans Radiology Nuclear Medicine and imaging In patient Referral and Consultation Aged Netherlands Retrospective Studies business.industry Patient Selection Coronary Stenosis Percutaneous coronary intervention General Medicine medicine.disease Flow ratio Fractional Flow Reserve Myocardial invasive imaging Conventional PCI Cardiology Hydrodynamics Female Cardiology and Cardiovascular Medicine business coronary artery disease quantitative coronary angiography |
| Zdroj: | Publons European Heart Journal-Cardiovascular Imaging, 20(11), 1231-1238 European Heart Journal-Cardiovascular Imaging, 20(11), 1231-1238. OXFORD UNIV PRESS |
| ISSN: | 2047-2412 |
| Popis: | Aims Quantitative flow ratio (QFR) is a recently developed technique to calculate fractional flow reserve (FFR) based on 3D quantitative coronary angiography and computational fluid dynamics, obviating the need for a pressure-wire and hyperaemia induction. QFR might be used to guide patient selection for FFR and subsequent percutaneous coronary intervention (PCI) referral in hospitals not capable to perform FFR and PCI. We aimed to investigate the feasibility to use QFR to appropriately select patients for FFR referral. Methods and results Patients who underwent invasive coronary angiography in a hospital where FFR and PCI could not be performed and were referred to our hospital for invasive FFR measurement, were included. Angiogram images from the referring hospitals were retrospectively collected for QFR analysis. Based on QFR cut-off values of 0.77 and 0.86, our patient cohort was reclassified to ‘no referral’ (QFR ≥0.86), referral for ‘FFR’ (QFR 0.78–0.85), or ‘direct PCI’ (QFR ≤0.77). In total, 290 patients were included. Overall accuracy of QFR to detect an invasive FFR of ≤0.80 was 86%. Based on a QFR cut-off value of 0.86, a 50% reduction in patient referral for FFR could be obtained, while only 5% of these patients had an invasive FFR of ≤0.80 (thus, these patients were incorrectly reclassified to the ‘no referral’ group). Furthermore, 22% of the patients that still need to be referred could undergo direct PCI, based on a QFR cut-off value of 0.77. Conclusion QFR is feasible to use for the selection of patients for FFR referral. |
| Databáze: | OpenAIRE |
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