TY - JOUR
T1 - Basal stenosis resistance index derived from simultaneous pressure and flow velocity measurements
AU - van de Hoef, Tim P.
AU - Petraco, Ricardo
AU - van Lavieren, Martijn A.
AU - Nijjer, Sukhjinder
AU - Nolte, Froukje
AU - Sen, Sayan
AU - Echavarria-Pinto, Mauro
AU - Henriques, José P. S.
AU - Koch, Karel T.
AU - Baan, Jan
AU - de Winter, Robbert J.
AU - Siebes, Maria
AU - Spaan, Jos A. E.
AU - Tijssen, Jan G. P.
AU - Meuwissen, Martijn
AU - Escaned, Javier
AU - Davies, Justin E.
AU - Piek, Jan J.
PY - 2016
Y1 - 2016
N2 - Vasodilator-free basal stenosis resistance (BSR) equals fractional flow reserve (FFR) accuracy for ischaemia-inducing stenoses. Nonetheless, basal haemodynamic variability may impair BSR accuracy compared with hyperaemic stenosis resistance (HSR). We evaluated the influence of basal haemodynamic variability, as encountered in practice, on BSR accuracy versus HSR when derived from simultaneous pressure and flow velocity measurements, and determined its diagnostic performance for HSR-defined significant stenoses. Simultaneous coronary pressure and flow velocity were obtained in 131 stenoses. The impact of basal haemodynamic conditions on BSR was evaluated by means of their relationship with the relative difference between BSR and HSR. Diagnostic performance of BSR, FFR, iFR, and resting Pd/Pa was assessed by comparing the area under the curve (AUC), using HSR as reference standard. The relative difference between BSR and HSR was not associated with basal heart rate, aortic pressure or rate pressure product. Among all stenoses, as well as within the 0.6-0.9 FFR range, BSR AUC was significantly greater than resting Pd/Pa and iFR AUC; all other AUCs were equivalent. With simultaneous pressure and flow velocity measurements, basal conditions do not systematically limit BSR accuracy compared with HSR. Consequently, diagnostic performance of BSR is equivalent to FFR, and closely approximates HSR
AB - Vasodilator-free basal stenosis resistance (BSR) equals fractional flow reserve (FFR) accuracy for ischaemia-inducing stenoses. Nonetheless, basal haemodynamic variability may impair BSR accuracy compared with hyperaemic stenosis resistance (HSR). We evaluated the influence of basal haemodynamic variability, as encountered in practice, on BSR accuracy versus HSR when derived from simultaneous pressure and flow velocity measurements, and determined its diagnostic performance for HSR-defined significant stenoses. Simultaneous coronary pressure and flow velocity were obtained in 131 stenoses. The impact of basal haemodynamic conditions on BSR was evaluated by means of their relationship with the relative difference between BSR and HSR. Diagnostic performance of BSR, FFR, iFR, and resting Pd/Pa was assessed by comparing the area under the curve (AUC), using HSR as reference standard. The relative difference between BSR and HSR was not associated with basal heart rate, aortic pressure or rate pressure product. Among all stenoses, as well as within the 0.6-0.9 FFR range, BSR AUC was significantly greater than resting Pd/Pa and iFR AUC; all other AUCs were equivalent. With simultaneous pressure and flow velocity measurements, basal conditions do not systematically limit BSR accuracy compared with HSR. Consequently, diagnostic performance of BSR is equivalent to FFR, and closely approximates HSR
U2 - https://doi.org/10.4244/EIJV12I2A33
DO - https://doi.org/10.4244/EIJV12I2A33
M3 - Article
C2 - 27290679
SN - 1774-024X
VL - 12
SP - e199-e207
JO - Eurointervention
JF - Eurointervention
IS - 2
ER -