scholarly journals The association between intravascular ultrasound-derived echo-attenuation and quantitative flow ratio in intermediate coronary lesions

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Liang Geng ◽  
Yuan Yuan ◽  
Peizhao Du ◽  
Liming Gao ◽  
Yunkai Wang ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Flow Ratio ◽  
Coronary Lesions ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

scholarly journals Impact of Arterial Remodeling of Intermediate Coronary Lesions on Long-Term Clinical Outcomes in Patients with Stable Coronary Artery Disease: An Intravascular Ultrasound Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Liang Geng ◽  
Peizhao Du ◽  
Yuan Yuan ◽  
Liming Gao ◽  
Yunkai Wang ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Intravascular Ultrasound ◽  
Clinical Event ◽  
Arterial Remodeling ◽  
Target Vessel ◽  
Flow Ratio ◽  
Coronary Lesions ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Background. Treatment of coronary intermediate lesions remains a controversy, and the role of arterial remodeling patterns determined by intravascular ultrasound in intermediate lesion is still not well known. The aim of this study was to investigate the impact of arterial remodeling of intermediate coronary lesions on long-term clinical outcomes. Methods. Arterial remodeling patterns were assessed in 212 deferred intermediate lesions from 162 patients after IVUS examination. Negative, intermediate, and positive remodeling was defined as a remodeling index of <0.88, 0.88∼1.0, and >1.0, respectively. The primary endpoint was the composite vessel-oriented clinical events, defined as the composition of target vessel-related cardiac death, target vessel-related myocardial infarction, and target vessel revascularization. Quantitative flow ratio was assessed for evaluating the functional significance of intermediate lesions. Results. 72 intermediate remodeling lesions were present in 66 patients, whereas 77 negative remodeling lesions were present in 71 patients, and 63 positive remodeling lesions were present in 55 patients. Negative remodeling lesions had the smallest minimum lumen area (4.16 ± 1.03 mm2 vs. 5.05 ± 1.39 mm2 vs. 4.85 ± 1.76 mm2; P < 0.01 ), smallest plaque burden (63.45 ± 6.13% vs. 66.12 ± 6.82% vs. 71.17 ± 6.45%; P < 0.01 ), and highest area stenosis rate (59.32% ± 10.15% vs. 54.61% ± 9.09% vs. 51.67% ± 12.96%; P < 0.01 ). No significant difference was found in terms of quantitative flow ratio among three groups. At 5 years follow-up, negative remodeling lesions had a higher rate of composite vessel-oriented clinical event (14.3%), compared to intermediate (1.4%, P = 0.004 ) or positive remodeling lesions (4.8%, P = 0.06 ). After adjusting for multiple covariates, negative remodeling remained an independent determinant for vessel-oriented clinical event (HR: 4.849, 95% CI 1.542–15.251, P = 0.007 ). Conclusion. IVUS-derived negative remodeling is associated with adverse long-term clinical outcome in stable patients with intermediate coronary artery stenosis.

scholarly journals Meta-Analysis of Diagnostic Performance of Instantaneous Wave-Free Ratio versus Quantitative Flow Ratio for Detecting the Functional Significance of Coronary Stenosis

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Wenjie Zuo ◽  
Mingming Yang ◽  
Yifan Chen ◽  
Aiming Xie ◽  
Lijuan Chen ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Coronary Stenosis ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Receiver Operating Curve ◽  
Flow Ratio ◽  
Fractional Flow ◽  
Coronary Lesions ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Background. Fractional flow reserve (FFR), as a functional measurement of coronary stenosis, is recommended for guiding revascularization in intermediate coronary lesions. However, it still remains underutilized for potential reasons including time consumption, costs, or contraindications associated with adenosine administration. Here we performed this meta-analysis to assess the diagnostic performance of two adenosine-free indices, instantaneous wave free-ratio (iFR), and quantitative flow ratio (QFR) in evaluating coronary stenosis severity with FFR as the reference standard. Methods. PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched to include relevant studies with the diagnostic accuracy of iFR or QFR referenced to FFR. A bivariate model was applied to pool diagnostic parameters. We used Cochran’s Q test and I2 index to assess heterogeneity and identify the potential source of heterogeneity by meta-regression. Results. A total of 8213 lesions from 28 studies (19 for iFR and 9 for QFR) were included in this meta-analysis. The pooled sensitivity and specificity were 0.79 (95% CI, 0.75 to 0.83) and 0.85 (95% CI, 0.82 to 0.87) for iFR and 0.90 (95% CI, 0.84 to 0.93) and 0.88 (95% CI, 0.86 to 0.90) for QFR, respectively. Significantly higher sensitivity and specificity were observed in the bivariate analysis for QFR than for iFR (P < 0.001 for both). The area under summary receiver-operating curve of iFR and QFR was 0.89 (95% CI, 0.86 to 0.92) and 0.92 (95% CI, 0.89 to 0.94). Conclusion. Evidence suggests that both of the two indices have good performance in detecting functional ischemia of coronary arteries and QFR might be a promising method without requiring the pressure wire. Further application of QFR may potentially provide important information to clinicians in the assessment of coronary lesions.

scholarly journals Performance of Integrated Near-Infrared Spectroscopy and Intravascular Ultrasound (NIRS-IVUS) System against Quantitative Flow Ratio (QFR)

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1148
Author(s):  
Magdalena M. Dobrolińska ◽  
Paweł M. Gąsior ◽  
Elżbieta Pociask ◽  
Grzegorz Smolka ◽  
Andrzej Ochala ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Intravascular Ultrasound ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Flow Ratio ◽  
Negative Group ◽  
Good Efficiency ◽  
Minimal Lumen Area ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Quantitative flow ratio (QFR) is a new opportunity to analyze functional stenosis during invasive coronary angiography. Together with a well-known intravascular ultrasound (IVUS) and a new player in the field, near-infrared spectroscopy (NIRS), it is gaining a lot of interest. The aim of the study was to compare QFR results with integrated IVUS-NIRS results acquired simultaneously in the same coronary lesion. We retrospectively enrolled 66 patients in whom 66 coronary lesions were assessed by NIRS-IVUS and QFR. Lesions were divided into two groups based on QFR results as QFR-positive group (QFR ≤ 0.8) or QFR-negative group (QFR > 0.8). Based on ROC curve analysis, the best cut-off values of minimal lumen area (MLA), minimal lumen diameter (MLD) and percent diameter stenosis for predicting QFR ≤ 80 were 2.4 (AUC 0.733, 95%CI 0.61, 0.834), 1.6 (AUC 0.768, 95%CI 0.634, 0.872) and 59.5 (AUC 0.918, 95%CI 0.824, 0.971), respectively. In QFR-positive lesions, the maxLCBI4mm was significantly higher than in QFR-negative lesions (450.12 ± 251.0 vs. 329.47 ± 191.14, p = 0.046). The major finding of the present study is that values of IVUS-MLA, IVUS-MLD and percent diameter stenosis show a good efficiency in predicting QFR ≤ 0.80. Moreover, QFR-positive lesions are characterized by higher maxLCBI4mm as compared to the QFR-negative group.

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