Non-hyperaemic pressure ratios to guide percutaneous coronary intervention
| Autor: | Udit Thakur, James D. Cameron, Stephen J. Nicholls, Stephen P. Hoole, Michael Michail, Adam J. Brown, Abdul Rahman Ihdayhid, Andrea Comella, Ojas H. Mehta, John M Ramzy |
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| Rok vydání: | 2020 |
| Předmět: |
Overall pressure ratio
medicine.medical_specialty Cardiac Catheterization coronary physiology medicine.medical_treatment Clinical Decision-Making Diastole Fractional flow reserve Coronary Artery Disease 030204 cardiovascular system & hematology Cardiac Catheters 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Predictive Value of Tests Internal medicine Coronary Circulation Transducers Pressure Medicine Humans Arterial Pressure 030212 general & internal medicine angina - unstable coronary pressure fractional flow reserve coronary intervention (PCI) business.industry Mean Aortic Pressure Percutaneous coronary intervention Guideline Interventional Cardiology Fractional Flow Reserve Myocardial Catheter medicine.anatomical_structure Treatment Outcome Cardiology Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Open Heart |
| ISSN: | 2053-3624 |
| Popis: | The use of fractional flow reserve (FFR) in guiding revascularisation improves patient outcomes and has been well-established in clinical guidelines. Despite this, the uptake of FFR has been limited, likely attributable to the perceived increase in procedural time and use of hyperaemic agents that can cause patient discomfort. This has led to the development of instantaneous wave-free ratio (iFR), an alternative non-hyperaemic pressure ratio (NHPR). Since its inception, the use of iFR has been supported by an increasing body of evidence and is now guideline recommended. More recently, other commercially available NHPRs including diastolic hyperaemia-free ratio and resting full-cycle ratio have emerged. Studies have demonstrated that these indices, in addition to mean distal coronary artery pressure to mean aortic pressure ratio, are mathematically analogous (with specific nuances) to iFR. Additionally, there is increasing data demonstrating the equivalent diagnostic performance of alternative NHPRs in comparison with iFR and FFR. These NHPRs are now integral within most current pressure wire systems and are commonly available in the catheter laboratory. It is therefore key to understand the fundamental differences and evidence for NHPRs to guide appropriate clinical decision-making. |
| Databáze: | OpenAIRE |
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