Plaque characteristics on coronary CT angiography associated with the positive findings of fractional flow reserve and instantaneous wave-free ratio
Plaque characteristics on coronary CT angiography associated with the positive findings of fractional flow reserve and instantaneous wave-free ratio
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冠状动脉CT血管造影的斑块特征与血流储备分数和瞬时无波比阳性结果相关
DOI：
10.1007/s00380-020-01722-w
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发表时间：
2021
影响因子：
1.5
通讯作者：
Daida Hiroyuki
中科院分区：
文献类型：
--
作者：
Aoshima Chihiro;Fujimoto Shinichiro;Kawaguchi Yuko O.;Dohi Tomotaka;Kamo Yuki;Takamura Kazuhisa;Hiki Makoto;Kato Yoshiteru;Okai Iwao;Okazaki Shinya;Kumamaru Kanako K.;Aoki Shigeki;Daida Hiroyuki
分数血流储备（FFR）和瞬时无波比（iFR）在确定冠状动脉疾病（CAD）的血运重建指征方面是有用的。虽然FFR和iFR的不一致约占20%，但这一原因尚未得到很好的确定。我们调查了患者的背景和冠状动脉CT血管造影（CCTA）的特征，不仅显示FFR和iFR阳性，而且FFR≤0.8和iFR≤0.89之间也存在不一致。方法对83例105条血管进行连续治疗，其中1条心外膜主要血管狭窄≥2mm的血管狭窄30-90%，在随后的90天内行FFR和iFR，其中疑似CAD的行CCTA。采用基于每位患者和每条血管的logistic回归分析，评估影响FFR和iFR阳性结果的因素，以及FFR和iFR之间的不一致性。结果ffr -阳性42例（40.0%），ifr -阳性34例（32.3%）。21例患者中有22条血管（21.0%）FFR≤0.8与iFR≤0.89不一致。在多因素logistic分析中，LAD （OR 3.55; 95%CI 1.20-11.71;p= 0.0217）和管腔容积/心肌重量（L/M）比（OR 0.93; 0.86-0.99,p= 0.0290）是ffr阳性结果的显著预测因子。对于ifr阳性结果，LAD （OR 3.86; 95%CI 1.12-13.31;p= 0.0236）是唯一显著的预测因子。在FFR≤0.8和iFR≤0.89组（15支，14.3%），阳性重构（PR） （OR 5.03, 95%CI 1.23-20.48,p= 0.0205）是显著预测因子。在FFR≤0.8和iFR≤0.89组（7只血管，6.7%），无显著预测因子。结论在CCTA特征方面，低l /Mratio是ffr阳性结果的相关预测因子。在FFR和iFR不一致的FFR阳性和iFR阴性患者中，PR是显著的预测因子。
BackgroundFractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are useful in determining indications for revascularization of coronary artery disease (CAD). Although the discordance of FFR and iFR was noted in approximately 20%, this cause has not been well established. We investigated patient background and features on coronary CT angiography (CCTA) showing not only FFR- and iFR-positive findings but also discordance between FFR ≤ 0.8 and iFR ≤ 0.89.MethodsSubjects were consecutively treated in 83 cases with 105 vessels in which stenosis of 30–90% was detected at one vessel of at least 2 mm or more in the major epicardial vessels and FFR and iFR was performed within subsequent 90 days, among suspected CAD which underwent CCTA. The factors affecting not only FFR- and iFR-positive findings, respectively, but also discordance between FFR and iFR was evaluated using logistic regression analysis on per-patient and per-vessel basis.ResultsFFR- and iFR-positive findings were observed in 42 vessels (40.0%) and 34 vessels (32.3%), respectively. Discordance between FFR ≤ 0.8 and iFR ≤ 0.89 was observed in 22 vessels (21.0%) of 21 patients. In multivariate logistic analysis, LAD (OR 3.55; 95%CI 1.20–11.71;p= 0.0217) and lumen volume/myocardial weight (L/M) ratio (OR 0.93; 0.86–0.99,p= 0.0290) were significant predictors for FFR-positive findings. For iFR-positive findings, LAD (OR 3.86; 95%CI 1.12–13.31;p= 0.0236) was only significant predictor. In FFR ≤ 0.8 and iFR > 0.89 group (15 vessels, 14.3%), positive remodeling (PR) (OR 5.03, 95%CI 1.23–20.48,p= 0.0205) was significant predictor. In FFR > 0.8 and iFR ≤ 0.89 group (7 vessels, 6.7%), there were no significant predictors.ConclusionOn CCTA characteristics, a relevant predictor for FFR-positive findings included lowL/Mratio. PR was significant predictor in FFR-positive, iFR-negative patients among those with discordance between the FFR and iFR.
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影响因子：
24
作者：
Chang HJ;Lin FY;Lee SE;Andreini D;Bax J;Cademartiri F;Chinnaiyan K;Chow BJW;Conte E;Cury RC;Feuchtner G;Hadamitzky M;Kim YJ;Leipsic J;Maffei E;Marques H;Plank F;Pontone G;Raff GL;van Rosendael AR;Villines TC;Weirich HG;Al'Aref SJ;Baskaran L;Cho I;Danad I;Han D;Heo R;Lee JH;Rivzi A;Stuijfzand WJ;Gransar H;Lu Y;Sung JM;Park HB;Berman DS;Budoff MJ;Samady H;Shaw LJ;Stone PH;Virmani R;Narula J;Min JK
通讯作者：
Min JK
影响因子：
5.4
作者：
Achenbach, Stephan;Boehmer, Kerstin;Marwan, Mohamed
通讯作者：
Marwan, Mohamed
血管造影中间冠状动脉狭窄中血流储备分数/瞬时无波比率不一致
DOI：
--
发表时间：
2017
期刊：
JACC: Cardiovascular Interventions
影响因子：
--
作者：
Christopher M. Cook;A. Jeremias;R. Petraco;S. Sen;S. Nijjer;M. Shun;Y. Ahmad;Guus A de Waard;T. P. van de Hoef;M. Echavarría;M. V. van Lavieren;Rasha Al Lamee;Y. Kikuta;Y. Shiono;A. Buch;M. Meuwissen;I. Danad;P. Knaapen;A. Maehara;B. Koo;G. Mintz;J. Escaned;G. Stone;D. Francis;J. Mayet;J. Piek;N. van Royen;J. Davies
通讯作者：
J. Davies
影响因子：
24
作者：
Jeremias, Allen;Maehara, Akiko;Stone, Gregg W.
通讯作者：
Stone, Gregg W.
影响因子：
14
作者：
Park, Hyung-Bok;Heo, Ran;Hartaigh, Briain O.;Cho, Iksung;Gransar, Heidi;Nakazato, Ryo;Leipsic, Jonathon;Mancini, G. B. John;Koo, Bon-Kwon;Otake, Hiromasa;Budoff, Matthew J.;Berman, Daniel S.;Erglis, Andrejs;Chang, Hyuk-Jae;Min, James K.
通讯作者：
Min, James K.