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Predictive factors of discordance between the instantaneous wave-free ratio and fractional flow reserve.

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dc.contributor.authorDérimay, F
dc.contributor.authorJohnson, N
dc.contributor.authorZimmermann, F
dc.contributor.authorAdjedj, J
dc.contributor.authorWitt, N
dc.contributor.authorHennigan, B
dc.contributor.authorKoo, B
dc.contributor.authorBarbato, E
dc.contributor.authorEsposito, G
dc.contributor.authorTrimarco, B
dc.contributor.authorRioufol, G
dc.contributor.authorBaptista, SB
dc.contributor.authorChrysant, G, et al.
dc.date.accessioned2019-02-15T10:35:13Z
dc.date.available2019-02-15T10:35:13Z
dc.date.issued2019
dc.description.abstractOBJECTIVES: To identify clinical, angiographic and hemodynamic predictors of discordance between instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR). BACKGROUND: The iFR was found to be non-inferior to the gold-standard FFR for guiding coronary revascularization, although it is discordant with FFR in 20% of cases. A better understanding of the causes of discordance may enhance application of these indices. METHODS: Both FFR and iFR were measured in the prospective multicenter CONTRAST study. Clinical, angiographic and hemodynamic variables were compared between patients with concordant values of FFR and iFR (cutoff ≤0.80 and ≤0.89, respectively). RESULTS: Out of the 587 patients included, in 466 patients (79.4%) FFR and iFR agreed: both negative, n = 244 (41.6%), or positive, n = 222 (37.8%). Compared with FFR, iFR was negative discordant (FFR+/iFR-) in 69 (11.8%) patients and positive discordant (FFR-/iFR+) in 52 (8.9%) patients. On multivariate regression, stenosis location (left main or proximal left anterior descending) (OR: 3.30[1.68;6.47]), more severe stenosis (OR: 1.77[1.35;2.30]), younger age (OR: 0.93[0.90;0.97]), and slower heart rate (OR: 0.59[0.42;0.75]) were predictors of a negative discordant iFR. Absence of a beta-blocker (OR: 0.41[0.22;0.78]), older age (OR: 1.04[1.00;1.07]), and less severe stenosis (OR: 0.69[0.53;0.89]) were predictors of a positive discordant iFR. CONCLUSIONS: During iFR acquisition, stenosis location, stenosis degree, heart rate, age and use of beta blockers influence concordance with FFR and should be taken into account when interpreting iFR.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationCatheter Cardiovasc Interv. 2019 Jan 31.pt_PT
dc.identifier.doi10.1002/ccd.28116pt_PT
dc.identifier.issn1522-726X
dc.identifier.urihttp://hdl.handle.net/10400.10/2114
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectCoronary stenosispt_PT
dc.subjectMyocardial fractional flow reservept_PT
dc.titlePredictive factors of discordance between the instantaneous wave-free ratio and fractional flow reserve.pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceNew Yorkpt_PT
oaire.citation.titleCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.pt_PT
rcaap.rightsclosedAccesspt_PT
rcaap.typearticlept_PT

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