Prognostic Implications of Resistive Reserve Ratio in Patients With Coronary Artery Disease

Autor: Seung Hun Lee, Joo Myung Lee, Jonghanne Park, Ki Hong Choi, Doyeon Hwang, Joon‐Hyung Doh, Chang‐Wook Nam, Eun‐Seok Shin, Masahiro Hoshino, Tadashi Murai, Taishi Yonetsu, Hernán Mejía‐Rentería, Tsunekazu Kakuta, Javier Escaned
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 9, Iss 8 (2020)
Druh dokumentu: article
ISSN: 2047-9980
DOI: 10.1161/JAHA.119.015846
Popis: Background Resistive reserve ratio is a thermodilution‐based index which integrates both coronary flow and pressure. Resistive reserve ratio represents the vasodilatory capacity of interrogated vessels including both epicardial coronary artery and microvascular circulation. We evaluated the prognostic potential of resistive reserve ratio compared with pressure‐derived index (fractional flow reserve [FFR]) or flow‐derived index (coronary flow reserve [CFR]). Methods and Results A total of 1245 patients underwent coronary pressure and flow measurement using pressure‐temperature wire. Resistive reserve ratio was calculated by CFR adjusted using the ratio between resting and hyperemic distal coronary pressure ([resting mean transit time/hyperemic mean transit time]×[resting distal coronary pressure/hyperemic distal coronary pressure]). Clinical outcome was assessed by patient‐oriented composite outcome (POCO), a composite of any death, myocardial infarction, and revascularization at 5 years. At 5 years, the cumulative incidence of POCO was significantly different according to quartiles of resistive reserve ratio (9.9%, 11.3%, 17.2%, and 22.7% in quartiles 1 to 4, respectively, log rank P0.80 or patients with CFR>2.0. (FFR>0.80 group: 14.8% versus 6.0%; log rank P=0.001; CFR>2.0 group: 13.5% versus 7.1%; log rank P=0.045). Adding resistive reserve ratio into the model for 5‐year POCO showed significantly higher global Chi square value than FFR or CFR (P
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