OPTIMAL CUT-OFF POINTS OF INSTANTANEOUS WAVE-FREE RATIO IN THE ASSESSMENT OF THE FUNCTIONAL SIGNIFICANCE OF CORONARY ARTERY STENOSES USING NONINVASIVE METHODS AS REFERENCE
ABSTRACT Objective: the aim of our study was to determine the optimal instantaneous wave-free ratio (iFR) cut-off points in assessing the functional significance of intermediate coronary artery stenoses in patients with chronic coronary artery diseases (CAD) using non-invasive methods of myocardial...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
InterMedservice
2016-12-01
|
| Series: | Евразийский Кардиологический Журнал |
| Online Access: | https://www.heartj.asia/jour/article/view/6190 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849692870698598400 |
|---|---|
| author | D. I. Darenskiy V. V. Gramovich E. A. Zharova M. G. Mitroshkin R. V. Atanesyan G. N. Bakashvili Y. G. Matchin |
| author_facet | D. I. Darenskiy V. V. Gramovich E. A. Zharova M. G. Mitroshkin R. V. Atanesyan G. N. Bakashvili Y. G. Matchin |
| author_sort | D. I. Darenskiy |
| collection | DOAJ |
| description | ABSTRACT Objective: the aim of our study was to determine the optimal instantaneous wave-free ratio (iFR) cut-off points in assessing the functional significance of intermediate coronary artery stenoses in patients with chronic coronary artery diseases (CAD) using non-invasive methods of myocardial ischemia verification as reference. Methods: 60 patients with chronic CAD or suspected CAD and intermediate coronary stenoses (50-70%) were included in the study. 92 borderline coronary stenoses were investigated. iFR measurement was carried out within 10 days after the non-invasive stress test (a combination of stress echocardiography and SPECT). Results: stress-induced myocardial ischemia was detected in 18 patients (30%). iFR values are in the range 0.68 to 1.0, median of iFR - 0.95 [0.9; 0.99]. Area under iFR ROC-curve - 0.95 ± 0.02 (95%CI: 0.885-0.985). The iFR cut-off point 0.92 is optimal and has a sensitivity of 100%, a specificity of 83% and a negative predictive value (NPV) of 100%. The iFR cut-off point 0.86 is associated with a specificity of 100%, a sensitivity of 33% and a positive predictive value of 100%. The values of iFR «grey» zone ranged from 0.87 to 0.92. Conclusion: using non-invasive methods of verification of myocardial ischemia as a reference, iFR cut-off point 0.92 excludes the functional significance of coronary artery stenosis with a NPV of 100%. iFR cut-off point 0.86 confirms the functional significance of the stenosis with a PPV of 100%. It is recommended to measure the fractional flow reserve in the case of obtaining the iFR values of «grey» zone (0,87-0,92). Key words: iFR, CAD, stress-echo, SPECT. |
| format | Article |
| id | doaj-art-366df3828a9a4fc389de8aafc230e001 |
| institution | DOAJ |
| issn | 2225-1685 2305-0748 |
| language | Russian |
| publishDate | 2016-12-01 |
| publisher | InterMedservice |
| record_format | Article |
| series | Евразийский Кардиологический Журнал |
| spelling | doaj-art-366df3828a9a4fc389de8aafc230e0012025-08-20T03:20:36ZrusInterMedserviceЕвразийский Кардиологический Журнал2225-16852305-07482016-12-0104344110.38109/2225-1685-2016-4-34-416187OPTIMAL CUT-OFF POINTS OF INSTANTANEOUS WAVE-FREE RATIO IN THE ASSESSMENT OF THE FUNCTIONAL SIGNIFICANCE OF CORONARY ARTERY STENOSES USING NONINVASIVE METHODS AS REFERENCED. I. Darenskiy0V. V. Gramovich1E. A. Zharova2M. G. Mitroshkin3R. V. Atanesyan4G. N. Bakashvili5Y. G. Matchin6Russian Cardiology Research and Production ComplexRussian Cardiology Research and Production ComplexRussian Cardiology Research and Production ComplexRussian Cardiology Research and Production ComplexRussian Cardiology Research and Production ComplexRussian Cardiology Research and Production ComplexRussian Cardiology Research and Production ComplexABSTRACT Objective: the aim of our study was to determine the optimal instantaneous wave-free ratio (iFR) cut-off points in assessing the functional significance of intermediate coronary artery stenoses in patients with chronic coronary artery diseases (CAD) using non-invasive methods of myocardial ischemia verification as reference. Methods: 60 patients with chronic CAD or suspected CAD and intermediate coronary stenoses (50-70%) were included in the study. 92 borderline coronary stenoses were investigated. iFR measurement was carried out within 10 days after the non-invasive stress test (a combination of stress echocardiography and SPECT). Results: stress-induced myocardial ischemia was detected in 18 patients (30%). iFR values are in the range 0.68 to 1.0, median of iFR - 0.95 [0.9; 0.99]. Area under iFR ROC-curve - 0.95 ± 0.02 (95%CI: 0.885-0.985). The iFR cut-off point 0.92 is optimal and has a sensitivity of 100%, a specificity of 83% and a negative predictive value (NPV) of 100%. The iFR cut-off point 0.86 is associated with a specificity of 100%, a sensitivity of 33% and a positive predictive value of 100%. The values of iFR «grey» zone ranged from 0.87 to 0.92. Conclusion: using non-invasive methods of verification of myocardial ischemia as a reference, iFR cut-off point 0.92 excludes the functional significance of coronary artery stenosis with a NPV of 100%. iFR cut-off point 0.86 confirms the functional significance of the stenosis with a PPV of 100%. It is recommended to measure the fractional flow reserve in the case of obtaining the iFR values of «grey» zone (0,87-0,92). Key words: iFR, CAD, stress-echo, SPECT.https://www.heartj.asia/jour/article/view/6190 |
| spellingShingle | D. I. Darenskiy V. V. Gramovich E. A. Zharova M. G. Mitroshkin R. V. Atanesyan G. N. Bakashvili Y. G. Matchin OPTIMAL CUT-OFF POINTS OF INSTANTANEOUS WAVE-FREE RATIO IN THE ASSESSMENT OF THE FUNCTIONAL SIGNIFICANCE OF CORONARY ARTERY STENOSES USING NONINVASIVE METHODS AS REFERENCE Евразийский Кардиологический Журнал |
| title | OPTIMAL CUT-OFF POINTS OF INSTANTANEOUS WAVE-FREE RATIO IN THE ASSESSMENT OF THE FUNCTIONAL SIGNIFICANCE OF CORONARY ARTERY STENOSES USING NONINVASIVE METHODS AS REFERENCE |
| title_full | OPTIMAL CUT-OFF POINTS OF INSTANTANEOUS WAVE-FREE RATIO IN THE ASSESSMENT OF THE FUNCTIONAL SIGNIFICANCE OF CORONARY ARTERY STENOSES USING NONINVASIVE METHODS AS REFERENCE |
| title_fullStr | OPTIMAL CUT-OFF POINTS OF INSTANTANEOUS WAVE-FREE RATIO IN THE ASSESSMENT OF THE FUNCTIONAL SIGNIFICANCE OF CORONARY ARTERY STENOSES USING NONINVASIVE METHODS AS REFERENCE |
| title_full_unstemmed | OPTIMAL CUT-OFF POINTS OF INSTANTANEOUS WAVE-FREE RATIO IN THE ASSESSMENT OF THE FUNCTIONAL SIGNIFICANCE OF CORONARY ARTERY STENOSES USING NONINVASIVE METHODS AS REFERENCE |
| title_short | OPTIMAL CUT-OFF POINTS OF INSTANTANEOUS WAVE-FREE RATIO IN THE ASSESSMENT OF THE FUNCTIONAL SIGNIFICANCE OF CORONARY ARTERY STENOSES USING NONINVASIVE METHODS AS REFERENCE |
| title_sort | optimal cut off points of instantaneous wave free ratio in the assessment of the functional significance of coronary artery stenoses using noninvasive methods as reference |
| url | https://www.heartj.asia/jour/article/view/6190 |
| work_keys_str_mv | AT didarenskiy optimalcutoffpointsofinstantaneouswavefreeratiointheassessmentofthefunctionalsignificanceofcoronaryarterystenosesusingnoninvasivemethodsasreference AT vvgramovich optimalcutoffpointsofinstantaneouswavefreeratiointheassessmentofthefunctionalsignificanceofcoronaryarterystenosesusingnoninvasivemethodsasreference AT eazharova optimalcutoffpointsofinstantaneouswavefreeratiointheassessmentofthefunctionalsignificanceofcoronaryarterystenosesusingnoninvasivemethodsasreference AT mgmitroshkin optimalcutoffpointsofinstantaneouswavefreeratiointheassessmentofthefunctionalsignificanceofcoronaryarterystenosesusingnoninvasivemethodsasreference AT rvatanesyan optimalcutoffpointsofinstantaneouswavefreeratiointheassessmentofthefunctionalsignificanceofcoronaryarterystenosesusingnoninvasivemethodsasreference AT gnbakashvili optimalcutoffpointsofinstantaneouswavefreeratiointheassessmentofthefunctionalsignificanceofcoronaryarterystenosesusingnoninvasivemethodsasreference AT ygmatchin optimalcutoffpointsofinstantaneouswavefreeratiointheassessmentofthefunctionalsignificanceofcoronaryarterystenosesusingnoninvasivemethodsasreference |