Diagnostic concordance and influencing factors of quantitative flow fraction and fractional flow reserve
10.3969/j.issn.1004-8812.2024.09.001
- VernacularTitle:定量血流分数和血流储备分数的诊断一致性和影响因素
- Author:
Rui-Tao ZHANG
1
;
Peng-Xin XIE
;
Zhen-Yu TIAN
;
Lin MI
;
Ji-Sheng ZHOU
;
Ben-Zhen WU
;
Li-Yun HE
;
Li-Jun GUO
Author Information
1. 北京大学第三医院心内科 血管医学研究所 血管稳态与重构全国重点实验室 国家卫生健康委心血管分子生物学与调节肽重点实验室 心血管受体研究北京市重点实验室,北京 100191
- Keywords:
Fractional flow reserve;
Quantitative flow fraction;
Coronary functional significance evaluation;
Coronary angiography-based index of microcirculatory resistance
- From:
Chinese Journal of Interventional Cardiology
2024;32(9):481-488
- CountryChina
- Language:Chinese
-
Abstract:
Objective This study aimed to explore the diagnostic concordance of fractional flow reserve(FFR)and quantitative flow ratio(QFR)and the characteristics affecting this concordance.Methods Patients with non-acute myocardial infarction admitted to the Department of Cardiology,Peking University Third Hospital between January 2019 and December 2021 were enrolled.The patients were divided into four groups:FFR+/QFR+and FFR-/QFR-,FFR+/QFR-and FFR-/QFR+with FFR or QFR≤0.80 as positive and＞0.80 as negative.Using FFR as the gold standard,the diagnostic value of QFR was analyzed,and differences in clinical features and pathological characteristics among the groups were compared.Results A total of 236 patients were included.The mean age was(64.48±9.63)years,and 67.8％were male.All patients had 30％-70％coronary stenosis.The consistency rate of QFR and FFR was 78.0％(n=184),and the Person correlation coefficient was 0.557(P＜0.001).Among FFR+patients,the minimum lumen diameter was larger[(1.56±0.34)mm vs.(1.39±0.31)mm,P=0.019],lesion length was shorter[(21.37±11.73)mm vs.(36.86±18.09)mm,P＜0.001],and coronary angiography-based index of microcirculartory resistance(AMR)was higher[(277.50±28.87)mmHg·s/m vs.(178.02±49.13)mmHg·s/m,P＜0.001]in the disconcordance group.Multivariate regression analysis suggested that AMR[OR 0.93,95％CI 0.88-0.99,P=0.030]and lesion length[OR 1.27,95％CI 1.01-1.60,P=0.045]were independent predictors of disconcordance.In the FFR-group,the lesion length was longer[(33.08±16.05)mm vs.(21.40±13.36)mm,P=0.020],and AMR[(169.66±24.01)mmHg·s/m vs.(265.95±44.78)mmHg·s/m,P＜0.001]and low-density lipoprotein-C[1.57(1.10,1.97)mmol/L vs.2.15(1.79,2.74)mmol/L,P=0.031]were lower in the disconcordance group.No statistically significant variables were identified by multivariate regression.Conclusions QFR had high diagnostic value compared with FFR.In the FFR+group,AMR and lesion length may have affected the diagnostic consistency of QFR and FFR.The study provided more evidence for the clinical application of QFR.
