Contrast FFR plus intracoronary injection of nitroglycerine accurately predicts FFR for coronary stenosis functional assessment
| Autor: | José F. Díaz-Fernández, Livia L. Gheorghe, Rafael Vázquez-García, Dolores Cañadas-Pruaño, Inara Alarcon-Lastra, Santiago Camacho-Freire, Juan Enrique Puche, Inmaculada Noval-Morillas, Etelvino Silva, Germán Calle-Pérez, Alejandro Gutierrez-Barrios, Antonio Gómez-Menchero |
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| Rok vydání: | 2020 |
| Předmět: |
Glycerol
medicine.medical_specialty Receiver operating characteristic Physiological significance business.industry media_common.quotation_subject Coronary Stenosis Coronary Artery Disease Coronary stenosis Gold standard (test) Fractional flow reserve Fractional Flow Reserve Myocardial Multicenter study Internal medicine medicine Cardiology Humans Functional significance Contrast (vision) Prospective Studies Cardiology and Cardiovascular Medicine business media_common |
| Zdroj: | Minerva Cardiology and Angiology. |
| ISSN: | 2724-5772 |
| DOI: | 10.23736/s0026-4725.20.05354-2 |
| Popis: | Fractional flow reserve (FFR) is the "gold standard" for assessing the physiological significance of coronary disease. In the last decade, several alternative adenosine-free indexes have been proposed in order to facilitate the dissemination of the functional evaluation of coronary stenosis. Our aim was to investigate whether radiographic contrast plus intracoronary nitroglycerin (cFFR-NTG) can predict functional assessment of coronary stenosis offering superior diagnostic agreement with FFR compared to non-hyperemic indexes and contrast mediated FFR (cFFR).Three hundred twenty-nine lesions evaluated with pressure wire in 266 patients were prospectively included in this multicenter study.The ROC curves for cFFR-NTG using an FFR≤0.80 showed a higher accuracy in predicting FFR (AUC=0.97) than resting Pd/Pa (AUC=0.90, P0.01) and cFFR (AUC=0.93.5, P0.01). A significant (P0.01) strong correlation was found between FFR and the four analyzed indexes: Pd/Pa (r=0.78); iFR/RFR (r=0.73); cFFR(r=0.89) and cFFR-NTG (r=0.93). cFFR-NTG showed the closest agreement at Bland-Altman analysis. The cFFR-NTG cut off value0.84 showed the highest negative predictive value (88%), specificity (91%), sensitivity (94%) and accuracy (92%) of the studied indexes.Submaximal hyperemic adenosine-free indexes are an efficient alternative to adenosine for the physiological assessment of epicardial coronary disease. The most accurate index in predicting the functional significance of coronary stenosis using FFR as reference was cFFR-NTG. |
| Databáze: | OpenAIRE |
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