Correlation and Agreement of Quantitative Flow Ratio With Fractional Flow Reserve in Saphenous Vein Grafts
Background The applicability of quantitative flow ratio (QFR), a nonhyperemic, invasive coronary angiography‐derived computation of fractional flow reserve (FFR), has not been studied in coronary artery bypass grafts. We sought to explore the correlation and diagnostic agreement between QFR and FFR...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-11-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.034901 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850065612127076352 |
|---|---|
| author | Ruben W. de Winter Yvemarie B. O. Somsen Roel Hoek Pepijn A. van Diemen Ruurt A. Jukema Mathé P. Jonker Albert C. van Rossum Jos W. R. Twisk Rolf A. Kooistra Jasper Janssen Sina Porouchani Adriaan Wilgenhof Niels J. Verouden Ibrahim Danad Johan H. C. Reiber Alexander Nap Paul Knaapen |
| author_facet | Ruben W. de Winter Yvemarie B. O. Somsen Roel Hoek Pepijn A. van Diemen Ruurt A. Jukema Mathé P. Jonker Albert C. van Rossum Jos W. R. Twisk Rolf A. Kooistra Jasper Janssen Sina Porouchani Adriaan Wilgenhof Niels J. Verouden Ibrahim Danad Johan H. C. Reiber Alexander Nap Paul Knaapen |
| author_sort | Ruben W. de Winter |
| collection | DOAJ |
| description | Background The applicability of quantitative flow ratio (QFR), a nonhyperemic, invasive coronary angiography‐derived computation of fractional flow reserve (FFR), has not been studied in coronary artery bypass grafts. We sought to explore the correlation and diagnostic agreement between QFR and FFR in saphenous vein grafts (SVGs). Methods and Results A total of 129 prospectively included patients (mean age 73±8 years, 84% male) with prior coronary artery bypass grafting underwent invasive coronary angiography and pressure‐derived functional assessment in 150 nonoccluded SVGs. QFR dedicated angiography images of the SVGs were acquired and used for offline QFR computation. The diagnostic performance of QFR was compared with 2‐dimensional quantitative coronary angiography, using FFR as a reference. A threshold of ≤0.80 was used to define functional significance. QFR was successfully computed in 140 (93%) SVGs. We found a significant correlation between QFR and FFR (r=0.72, P<0.001). FFR indicated significant disease in 43 (31%) SVGs, whereas QFR analysis showed significant lesions in 53 (38%) bypass grafts. QFR exhibited a higher sensitivity and diagnostic accuracy compared with angiographic lesion assessment (84% versus 63%, P=0.030 and 83% versus 74%, P=0.036, respectively), whereas specificity did not differ (82% versus 79%, P=0.466). Lastly, QFR demonstrated a higher area under the receiver operating curve than quantitative coronary angiography (0.90 versus 0.82, P=0.008) for the detection of FFR‐defined significant vein graft disease. Conclusions This study shows the potential applicability of contemporary QFR computation in venous bypass grafts with a moderate correlation and good diagnostic accuracy compared with functional assessment using FFR. |
| format | Article |
| id | doaj-art-8f535eb3989842e9929ae2ad612d1020 |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-8f535eb3989842e9929ae2ad612d10202025-08-20T02:48:57ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-11-01132110.1161/JAHA.124.034901Correlation and Agreement of Quantitative Flow Ratio With Fractional Flow Reserve in Saphenous Vein GraftsRuben W. de Winter0Yvemarie B. O. Somsen1Roel Hoek2Pepijn A. van Diemen3Ruurt A. Jukema4Mathé P. Jonker5Albert C. van Rossum6Jos W. R. Twisk7Rolf A. Kooistra8Jasper Janssen9Sina Porouchani10Adriaan Wilgenhof11Niels J. Verouden12Ibrahim Danad13Johan H. C. Reiber14Alexander Nap15Paul Knaapen16Department of Cardiology Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The NetherlandsDepartment of Cardiology Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The NetherlandsDepartment of Cardiology Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The NetherlandsDepartment of Cardiology Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The NetherlandsDepartment of Cardiology Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The NetherlandsDepartment of Cardiology Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The NetherlandsDepartment of Cardiology Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The NetherlandsDepartment of Epidemiology & Data Science Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The NetherlandsMedis Medical Imaging Leiden The NetherlandsMedis Medical Imaging Leiden The NetherlandsDepartment of Cardiology Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The NetherlandsDepartment of Cardiology Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The NetherlandsDepartment of Cardiology Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The NetherlandsDepartment of Cardiology Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The NetherlandsMedis Medical Imaging Leiden The NetherlandsDepartment of Cardiology Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The NetherlandsDepartment of Cardiology Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The NetherlandsBackground The applicability of quantitative flow ratio (QFR), a nonhyperemic, invasive coronary angiography‐derived computation of fractional flow reserve (FFR), has not been studied in coronary artery bypass grafts. We sought to explore the correlation and diagnostic agreement between QFR and FFR in saphenous vein grafts (SVGs). Methods and Results A total of 129 prospectively included patients (mean age 73±8 years, 84% male) with prior coronary artery bypass grafting underwent invasive coronary angiography and pressure‐derived functional assessment in 150 nonoccluded SVGs. QFR dedicated angiography images of the SVGs were acquired and used for offline QFR computation. The diagnostic performance of QFR was compared with 2‐dimensional quantitative coronary angiography, using FFR as a reference. A threshold of ≤0.80 was used to define functional significance. QFR was successfully computed in 140 (93%) SVGs. We found a significant correlation between QFR and FFR (r=0.72, P<0.001). FFR indicated significant disease in 43 (31%) SVGs, whereas QFR analysis showed significant lesions in 53 (38%) bypass grafts. QFR exhibited a higher sensitivity and diagnostic accuracy compared with angiographic lesion assessment (84% versus 63%, P=0.030 and 83% versus 74%, P=0.036, respectively), whereas specificity did not differ (82% versus 79%, P=0.466). Lastly, QFR demonstrated a higher area under the receiver operating curve than quantitative coronary angiography (0.90 versus 0.82, P=0.008) for the detection of FFR‐defined significant vein graft disease. Conclusions This study shows the potential applicability of contemporary QFR computation in venous bypass grafts with a moderate correlation and good diagnostic accuracy compared with functional assessment using FFR.https://www.ahajournals.org/doi/10.1161/JAHA.124.034901fractional flow reservequantitative flow ratiosaphenous vein grafts |
| spellingShingle | Ruben W. de Winter Yvemarie B. O. Somsen Roel Hoek Pepijn A. van Diemen Ruurt A. Jukema Mathé P. Jonker Albert C. van Rossum Jos W. R. Twisk Rolf A. Kooistra Jasper Janssen Sina Porouchani Adriaan Wilgenhof Niels J. Verouden Ibrahim Danad Johan H. C. Reiber Alexander Nap Paul Knaapen Correlation and Agreement of Quantitative Flow Ratio With Fractional Flow Reserve in Saphenous Vein Grafts Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease fractional flow reserve quantitative flow ratio saphenous vein grafts |
| title | Correlation and Agreement of Quantitative Flow Ratio With Fractional Flow Reserve in Saphenous Vein Grafts |
| title_full | Correlation and Agreement of Quantitative Flow Ratio With Fractional Flow Reserve in Saphenous Vein Grafts |
| title_fullStr | Correlation and Agreement of Quantitative Flow Ratio With Fractional Flow Reserve in Saphenous Vein Grafts |
| title_full_unstemmed | Correlation and Agreement of Quantitative Flow Ratio With Fractional Flow Reserve in Saphenous Vein Grafts |
| title_short | Correlation and Agreement of Quantitative Flow Ratio With Fractional Flow Reserve in Saphenous Vein Grafts |
| title_sort | correlation and agreement of quantitative flow ratio with fractional flow reserve in saphenous vein grafts |
| topic | fractional flow reserve quantitative flow ratio saphenous vein grafts |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.034901 |
| work_keys_str_mv | AT rubenwdewinter correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT yvemariebosomsen correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT roelhoek correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT pepijnavandiemen correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT ruurtajukema correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT mathepjonker correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT albertcvanrossum correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT joswrtwisk correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT rolfakooistra correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT jasperjanssen correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT sinaporouchani correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT adriaanwilgenhof correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT nielsjverouden correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT ibrahimdanad correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT johanhcreiber correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT alexandernap correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts AT paulknaapen correlationandagreementofquantitativeflowratiowithfractionalflowreserveinsaphenousveingrafts |