Diagnostic accuracy of Murray law-based quantitative flow ratio in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement
© 2024. Springer Nature Japan KK, part of Springer Nature..
BACKGROUND: Murray law-based quantitative flow ratio (μQFR) is a novel computational method that enables accurate estimation of fractional flow reserve (FFR) using a single angiographic projection. However, its diagnostic value in patients with severe aortic stenosis (AS) remains unclear.
METHOD: We included 25 consecutive patients who underwent transcatheter aortic valve replacement (TAVR) for severe AS with intermediate or greater (30-90%) coronary artery disease (CAD). Pre- and post-TAVR μQFR, QFR, instantaneous flow reserve (iFR), and post-TAVR invasive FFR values were measured. We evaluated the diagnostic performance of pre-TAVR μQFR, QFR, and iFR using post-TAVR FFR ≤ 0.80 as a reference standard of ischemia.
RESULT: Pre-TAVR μQFR was significantly correlated with post-TAVR FFR (r = 0.73, p < 0.0001). The area under the curve of pre-TAVR μQFR on post-TAVR FFR ≤ 0.8 was 0.91 (95% confidence interval [CI] 0.77-0.98), comparable to that of pre-TAVR iFR (0.86 [95% CI 0.71-0.98], p = 0.97). The accuracy, sensitivity, specificity, and positive and negative predictive values of pre-TAVR μQFR on post-TAVR FFR ≤ 0.8 were 84.2% (95% CI 68.7-93.4), 61.6% (95% CI 31.6-86.1), 96.0% (95% CI 79.6-99.9), 88.9% (95% CI 52.9-98.3), and 82.8% (95% CI 70.6-90.6), respectively. For pre-TAVR iFR, these values were 76.5% (95% CI 58.8-89.3), 90.9% (95% CI 58.7-99.8), 69.6% (95% CI 47.1-86.8), 58.8% (95% CI 42.8-73.1), and 94.1% (95% CI 70.8-99.1), respectively.
CONCLUSION: μQFR could be useful for the physiological evaluation of patients with severe AS with concomitant CAD.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Heart and vessels - (2024) vom: 25. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Yuta, Fukuishi [VerfasserIn] |
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| Links: |
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| Themen: |
Coronary artery disease |
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| Anmerkungen: |
Date Revised 25.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1007/s00380-024-02387-5 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370163184 |
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| 245 | 1 | 0 | |a Diagnostic accuracy of Murray law-based quantitative flow ratio in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement |
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| 500 | |a published: Print-Electronic | ||
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| 520 | |a © 2024. Springer Nature Japan KK, part of Springer Nature. | ||
| 520 | |a BACKGROUND: Murray law-based quantitative flow ratio (μQFR) is a novel computational method that enables accurate estimation of fractional flow reserve (FFR) using a single angiographic projection. However, its diagnostic value in patients with severe aortic stenosis (AS) remains unclear | ||
| 520 | |a METHOD: We included 25 consecutive patients who underwent transcatheter aortic valve replacement (TAVR) for severe AS with intermediate or greater (30-90%) coronary artery disease (CAD). Pre- and post-TAVR μQFR, QFR, instantaneous flow reserve (iFR), and post-TAVR invasive FFR values were measured. We evaluated the diagnostic performance of pre-TAVR μQFR, QFR, and iFR using post-TAVR FFR ≤ 0.80 as a reference standard of ischemia | ||
| 520 | |a RESULT: Pre-TAVR μQFR was significantly correlated with post-TAVR FFR (r = 0.73, p < 0.0001). The area under the curve of pre-TAVR μQFR on post-TAVR FFR ≤ 0.8 was 0.91 (95% confidence interval [CI] 0.77-0.98), comparable to that of pre-TAVR iFR (0.86 [95% CI 0.71-0.98], p = 0.97). The accuracy, sensitivity, specificity, and positive and negative predictive values of pre-TAVR μQFR on post-TAVR FFR ≤ 0.8 were 84.2% (95% CI 68.7-93.4), 61.6% (95% CI 31.6-86.1), 96.0% (95% CI 79.6-99.9), 88.9% (95% CI 52.9-98.3), and 82.8% (95% CI 70.6-90.6), respectively. For pre-TAVR iFR, these values were 76.5% (95% CI 58.8-89.3), 90.9% (95% CI 58.7-99.8), 69.6% (95% CI 47.1-86.8), 58.8% (95% CI 42.8-73.1), and 94.1% (95% CI 70.8-99.1), respectively | ||
| 520 | |a CONCLUSION: μQFR could be useful for the physiological evaluation of patients with severe AS with concomitant CAD | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Coronary artery disease | |
| 650 | 4 | |a Fractional flow reserve | |
| 650 | 4 | |a Murray law-based quantitative flow ratio | |
| 650 | 4 | |a Transcatheter aortic valve replacement | |
| 700 | 1 | |a Kawamori, Hiroyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Toba, Takayoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Hiromasa, Takashi |e verfasserin |4 aut | |
| 700 | 1 | |a Sasaki, Satoru |e verfasserin |4 aut | |
| 700 | 1 | |a Hamana, Tomoyo |e verfasserin |4 aut | |
| 700 | 1 | |a Fujii, Hiroyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Osumi, Yuto |e verfasserin |4 aut | |
| 700 | 1 | |a Iwane, Seigo |e verfasserin |4 aut | |
| 700 | 1 | |a Yamamoto, Tetsuya |e verfasserin |4 aut | |
| 700 | 1 | |a Naniwa, Shota |e verfasserin |4 aut | |
| 700 | 1 | |a Sakamoto, Yuki |e verfasserin |4 aut | |
| 700 | 1 | |a Matsuhama, Koshi |e verfasserin |4 aut | |
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