TY - JOUR
T1 - Performance of quantitative flow ratio in patients with aortic stenosis undergoing transcatheter aortic valve implantation
AU - Sejr-Hansen, Martin
AU - Christiansen, Evald H. j
AU - Ahmad, Yousif
AU - Vendrik, Jeroen
AU - Westra, Jelmer
AU - Holm, Niels R.
AU - Thim, Troels
AU - Seligman, Henry
AU - Hall, Kerry
AU - Sen, Sayan
AU - Terkelsen, Christian Juhl
AU - Eftekhari, Ashkan
N1 - Funding Information: Software for QFR analysis was provided free of charge by Medis medical imaging System bv. Niels R. Holm received institutional research grants from Abbott, Boston Scientific, and Medis Medical Imaging bv. Publisher Copyright: © 2021 Wiley Periodicals LLC.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Objectives: This study aims to evaluate the diagnostic performance of quantitative flow ratio (QFR) pre transcatheter aortic valve implantation (TAVI) in patients with aortic valve stenosis (AS) and coronary artery disease (CAD). Post-TAVI fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) was used as reference. Background: CAD is prevalent in patients with AS, but the hemodynamics of AS confounds evaluation using pressure wire-based assessments. QFR might be less sensitive to the presence of AS thereby allowing for CAD evaluation before aortic valve replacement. Further, QFR does not require the use of pressure wire and therefore has the potential for reducing costs and complications related to insertion of a coronary pressure wire. Methods: The diagnostic performance of QFR in coronary angiograms from 28 patients undergoing TAVI was evaluated. In all patients, both FFR and iFR were measured pre- and immediately post-TAVI while QFR was measured pre-TAVI. Results: Using post-TAVI FFR and iFR as reference the diagnostic accuracy of pre-TAVI QFR were 83% (95%CI; 68–97) and 52% (95%CI; 30–74) p =.008, respectively. Conclusions: Pre-TAVI QFR showed a good diagnostic performance using post-TAVI FFR as reference. QFR could become a wire-free, safe, and quick way of evaluating CAD in patients with severe AS undergoing TAVI.
AB - Objectives: This study aims to evaluate the diagnostic performance of quantitative flow ratio (QFR) pre transcatheter aortic valve implantation (TAVI) in patients with aortic valve stenosis (AS) and coronary artery disease (CAD). Post-TAVI fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) was used as reference. Background: CAD is prevalent in patients with AS, but the hemodynamics of AS confounds evaluation using pressure wire-based assessments. QFR might be less sensitive to the presence of AS thereby allowing for CAD evaluation before aortic valve replacement. Further, QFR does not require the use of pressure wire and therefore has the potential for reducing costs and complications related to insertion of a coronary pressure wire. Methods: The diagnostic performance of QFR in coronary angiograms from 28 patients undergoing TAVI was evaluated. In all patients, both FFR and iFR were measured pre- and immediately post-TAVI while QFR was measured pre-TAVI. Results: Using post-TAVI FFR and iFR as reference the diagnostic accuracy of pre-TAVI QFR were 83% (95%CI; 68–97) and 52% (95%CI; 30–74) p =.008, respectively. Conclusions: Pre-TAVI QFR showed a good diagnostic performance using post-TAVI FFR as reference. QFR could become a wire-free, safe, and quick way of evaluating CAD in patients with severe AS undergoing TAVI.
KW - aortic stenosis
KW - coronary artery disease
KW - coronary physiology
KW - fractional flow reserve
KW - instantaneous wave-free ratio
KW - quantitative flow ratio
UR - http://www.scopus.com/inward/record.url?scp=85100382352&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/ccd.29518
DO - https://doi.org/10.1002/ccd.29518
M3 - Article
C2 - 33533535
SN - 1522-1946
VL - 99
SP - 68
EP - 73
JO - Catheterization and cardiovascular interventions
JF - Catheterization and cardiovascular interventions
IS - 1
ER -