Sex-Specific Interpretation of Coronary Flow Reserve and Fractional Flow Reserve Metrics, Including Their Companions

Autor: Peter L. M. Kerkhof, Elena Osto, Francesco Tona, Guy R. Heyndrickx, Neal Handly
Přispěvatelé: University of Zurich, Physics and medical technology, Radiology and nuclear medicine, ACS - Heart failure & arrhythmias
Rok vydání: 2019
Předmět:
Male
Cardiac Catheterization
medicine.medical_specialty
1707 Computer Vision and Pattern Recognition
2204 Biomedical Engineering
Friends
Hyperemia
610 Medicine & health
Fractional flow reserve
030204 cardiovascular system & hematology
Anterior Descending Coronary Artery
Coronary Angiography
Severity of Illness Index
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Internal medicine
540 Chemistry
medicine
Humans
030212 general & internal medicine
Pressure gradient
10038 Institute of Clinical Chemistry
2718 Health Informatics
Sex Characteristics
business.industry
Ultrasound
Coronary Stenosis
Mean Aortic Pressure
Coronary flow reserve
medicine.disease
Coronary Vessels
Fractional Flow Reserve
Myocardial
Benchmarking
Stenosis
medicine.anatomical_structure
Cardiology
Female
1711 Signal Processing
business
Blood Flow Velocity
Artery
Zdroj: EMBC
Kerkhof, P L M, Osto, E, Tona, F, Heyndrickx, G R & Handly, N 2019, Sex-Specific Interpretation of Coronary Flow Reserve and Fractional Flow Reserve Metrics, Including Their Companions . in 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2019 ., 8857589, Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS, Institute of Electrical and Electronics Engineers Inc., pp. 7006-7009, 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2019, Berlin, Germany, 23/07/2019 . https://doi.org/10.1109/EMBC.2019.8857589
2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2019, 7006-7009
STARTPAGE=7006;ENDPAGE=7009;TITLE=2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2019
DOI: 10.1109/embc.2019.8857589
Popis: BACKGROUND: Impairment of coronary flow is usually evaluated by considering the ratio of two measurements. Fractional flow reserve (FFR) estimates impact on an epicardial artery by taking mean post-stenotic pressure divided by mean aortic pressure, both obtained during adenosine induced hyperemia. Coronary flow reserve (CFR) compares hyperemic flow or velocity with the baseline situation, also as a ratio. As severity of underlying pathology may differ for men and women, we investigate the impact of these differences on relevant metrics.METHODS: As sex associated differences may cancel out in a ratio, this weakness of a ratio can be compensated by analyzing the intrinsic companion (C) and consider polar coordinates. Thus, besides the familiar ratio based metrics, we also analyze FFRC and CFRC. Outcomes of in silico studies are employed to extrapolate actual patient data and predict consequences. For FFR 129 patients (38 women) were invasively studied using pressure wires. CFR was measured noninvasively for the left anterior descending coronary artery by recording ultrasound based Doppler velocity in 114 individuals (28 women).RESULTS: The FFR can be identified as an indicator of the pressure gradient over the stenosis (R=-0.90), while FFRC differs for men compared to women (P=0.04) and correlates (R=0.93) with post-stenotic driving pressure. CFR shows a difference for men versus women (P=0.04) and is best associated with hyperemic flow (R=0.64), whereas CFRC relates to hyperemia recruited velocity (R=0.97). Simulation studies show that FFR may differ for both sexes when considering elderly.CONCLUSIONS: Analysis of ratios require inclusion of the companion, and sex-specific differences deserve attention.
Databáze: OpenAIRE
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