TY - JOUR
T1 - Fluid-filled versus sensor-tipped pressure guidewires for FFR and Pd/Pa measurement; PW-COMPARE study
AU - Eerdekens, Rob
AU - Tonino, Pim A. L.
AU - Zimmermann, Frederik M.
AU - Teeuwen, Koen
AU - Vlaar, Pieter-Jan
AU - de Waard, Guus A.
AU - van Royen, Niels
AU - van Nunen, Lokien X.
N1 - Publisher Copyright: © 2024 The Authors
PY - 2024
Y1 - 2024
N2 - Background: Fluid-filled pressure guidewires are unaffected by the previously inevitable hydrostatic pressure gradient (HPG). This study aimed to compare simultaneous pressure measurements with fluid-filled and sensor-tipped pressure guidewires. Methods: Fifty patients underwent fractional flow reserve (FFR) and P d/P a measurement with a fluid-filled and a sensor-tipped pressure guidewire simultaneously. To assess maneuverability, patients were randomized with respect to which pressure guidewire was used to cross the lesion first. Lateral fluoroscopy was used to estimate height difference between catheter tip and distal wire position (and thus HPG). Agreement between pressure measurements was studied. Results: Measurements were performed in LM (4% (n = 2)), LAD (44% (n = 22)), LCX (26% (n = 13)), and RCA (26% (n = 13)). Simultaneous pressure measurements showed excellent agreement (mean FFR difference − 0.01 ± 0.03 (r = 0.959, p < 0.001), mean P d/P a difference − 0.01 ± 0.04 (r = 0.929, p < 0.001)). FFR was ≤0.80 in 42.6% (n = 20) with fluid-filled FFR measurements versus 46.8% (n = 22) by sensor-tipped FFR measurements. Mean height difference was 15 ± 34 mm, and strongly dependent on the coronary artery (LAD 45 ± 10 mm, LCX −23 ± 16 mm, RCA −13 ± 17 mm). There was a strong correlation between height difference and difference in pressure ratios between sensor-tipped and fluid-filled pressure guidewires (FFR r = −0.850, p < 0.001; P d/P a r = −0.641, p < 0.001). Largest FFR differences were present in the LAD (−0.04 ± 0.02). After HPG correction, mean difference between HPG-corrected sensor-tipped FFR and fluid-filled FFR was 0.00 ± 0.02, mean P d/P a difference was 0.01 ± 0.03. Conclusions: This study shows excellent overall correlation between FFR and P d/P a measurements with both pressure guidewires. Differences measured with fluid-filled and sensor-tipped pressure guidewires are vessel-specific and attributable to hydrostatic pressure gradients (NCT04802681).
AB - Background: Fluid-filled pressure guidewires are unaffected by the previously inevitable hydrostatic pressure gradient (HPG). This study aimed to compare simultaneous pressure measurements with fluid-filled and sensor-tipped pressure guidewires. Methods: Fifty patients underwent fractional flow reserve (FFR) and P d/P a measurement with a fluid-filled and a sensor-tipped pressure guidewire simultaneously. To assess maneuverability, patients were randomized with respect to which pressure guidewire was used to cross the lesion first. Lateral fluoroscopy was used to estimate height difference between catheter tip and distal wire position (and thus HPG). Agreement between pressure measurements was studied. Results: Measurements were performed in LM (4% (n = 2)), LAD (44% (n = 22)), LCX (26% (n = 13)), and RCA (26% (n = 13)). Simultaneous pressure measurements showed excellent agreement (mean FFR difference − 0.01 ± 0.03 (r = 0.959, p < 0.001), mean P d/P a difference − 0.01 ± 0.04 (r = 0.929, p < 0.001)). FFR was ≤0.80 in 42.6% (n = 20) with fluid-filled FFR measurements versus 46.8% (n = 22) by sensor-tipped FFR measurements. Mean height difference was 15 ± 34 mm, and strongly dependent on the coronary artery (LAD 45 ± 10 mm, LCX −23 ± 16 mm, RCA −13 ± 17 mm). There was a strong correlation between height difference and difference in pressure ratios between sensor-tipped and fluid-filled pressure guidewires (FFR r = −0.850, p < 0.001; P d/P a r = −0.641, p < 0.001). Largest FFR differences were present in the LAD (−0.04 ± 0.02). After HPG correction, mean difference between HPG-corrected sensor-tipped FFR and fluid-filled FFR was 0.00 ± 0.02, mean P d/P a difference was 0.01 ± 0.03. Conclusions: This study shows excellent overall correlation between FFR and P d/P a measurements with both pressure guidewires. Differences measured with fluid-filled and sensor-tipped pressure guidewires are vessel-specific and attributable to hydrostatic pressure gradients (NCT04802681).
KW - Coronary physiology
KW - Fractional flow reserve
KW - Hydrostatic pressure gradient
KW - Non-hyperemic pressure ratios
UR - http://www.scopus.com/inward/record.url?scp=85189464555&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2024.131998
DO - 10.1016/j.ijcard.2024.131998
M3 - Article
C2 - 38555057
SN - 0167-5273
JO - International journal of cardiology
JF - International journal of cardiology
M1 - 131998
ER -