Validation of Resting Diastolic Pressure Ratio Calculated by a Novel Algorithm and Its Correlation With Distal Coronary Artery Pressure to Aortic Pressure, Instantaneous Wave-Free Ratio, and Fractional Flow Reserve The dPR Study
Validation of Resting Diastolic Pressure Ratio Calculated by a Novel Algorithm and Its Correlation With Distal Coronary Artery Pressure to Aortic Pressure, Instantaneous Wave-Free Ratio, and Fractional Flow Reserve The dPR Study
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DOI：
10.1161/circinterventions.118.006911
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发表时间：
2018-12-01
影响因子：
5.6
通讯作者：
Daemen, Joost
中科院分区：
文献类型：
--
作者：
Ligthart, Jurgen;Masdjedi, Kaneshka;Daemen, Joost
背景资料：瞬时无波比率（iFR）提供了冠状动脉生理学的可靠非充血评估，但需要具有全自动算法的专用专有软件。我们假设使用新型通用软件计算的dPR（舒张压比）与iFR具有很强的相关性，与静息远端冠状动脉压/主动脉压和血流储备分数（FFR）的诊断准确性相似。方法和结果：dPR研究是一项观察性、回顾性、单中心队列研究，包括接受iFR或FFR的患者。使用专用软件根据医学数字成像和通信（DICOM）压力波形计算dPR。样本之间的压力差（dP）与相同样本点之间的时间差（dt）信号的平坦周期用于自动检测电阻低且恒定的周期，并计算dPR，其为5次连续心跳的平均值。通过将iFR结果与dPR相关联来验证该软件。通过比较44例接受iFR的患者的78个iFR测量值进行软件确认。平均iFR和dPR分别为0.91 ± 0.10和0.92 ± 0.10，具有显著的线性相关性（R=0.997; P
Background: Instantaneous wave-free ratio (iFR) offers a reliable non-hyperemic assessment of coronary physiology but requires dedicated proprietary software with a fully automated algorithm. We hypothesized that dPR (diastolic pressure ratio), calculated with novel universal software, has a strong correlation with iFR, similar diagnostic accuracy relative to resting distal coronary artery pressure/aortic pressure and fractional flow reserve (FFR). Methods and Results: The dPR study is an observational, retrospective, single-center cohort study including patients who underwent iFR or FFR. Dedicated software was used to calculate the dPR from Digital Imaging and Communications in Medicine (DICOM) pressure waveforms. The flat period on the pressure difference between sample (dP) to the time difference between the same sample points (dt) signal was used to detect automatically the period, where the resistance is low and constant, and to calculate the dPR, which is an average over 5 consecutive heartbeats. The software was validated by correlating iFR results with dPR. Software validation was done by comparing 78 iFR measurements in 44 patients who underwent iFR. Mean iFR and dPR were 0.91 +/- 0.10 and 0.92 +/- 0.10, respectively, with a significant linear correlation (R=0.997; P