Alejandro Gutiérrez-Barrios , Santiago Camacho-Freire , Miguel Alba-Sánchez , Jorge Chavarria-Viquez , Soledad Ojeda-Pineda , Diana Villanueva-Ospino , Dolores Cañadas-Pruaño , Germán Calle-Pérez , Jesús Oneto-Otero , José F. Diaz-Fernández , Manuel Pan-Álvarez Ossorio , Rafael Vázquez-García
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引用次数: 0
Abstract
Introduction
Recently, there has been renewed interest in new coronary physiological indexes. Our aim was to investigate the correlation of resting baseline Pd/Pa and cFFR with FFR in real life patients and to test the accuracy of Pd/Pa and cFFR compare to FFR.
Material and methods
Multicenter prospective Study of patients with intermediate coronary stenosis functionally assessed by the ratio of distal coronary pressure and aortic pressure at rest (Pd/Pa), FFR and cFFR.
Results
70 patients (80 coronary lesions) were enrolled. Pd/Pa(r=0.82, P<.001) and cFFR (r=0.89, P<.001) showed a good correlation with FFR.
Based on the established FFR cutoff threshold of 0.8 to define a positive result, 44 (55%) lesions were functionally significant
ROC curve analysis of Pd/Pa and cFFR showed an area under the curve of 0.91 (95% IC 0.85-0.98) and 0.91 (95% IC 0.85-0.97) respectively.
The best cutoff values were >0.92 and >0.85 showing both of them a negative predictive value of 80%, a sensitivity of 84% and a specificity of 75% and 83% respectively.
Conclusions
Pd/PA but specially cFFR is accurate in predicting the functional significance of coronary stenosis. This could allow, in some cases, avoid the use of adenosine savings costs and time.
最近,人们对新的冠状动脉生理指标重新产生了兴趣。我们的目的是研究现实生活中患者静息基线Pd/Pa和cFFR与FFR的相关性,并比较Pd/Pa和cFFR与FFR的准确性。材料与方法对中度冠状动脉狭窄患者进行多中心前瞻性研究,采用静息时冠状动脉远端压与主动脉压之比(Pd/Pa)、FFR和cFFR进行功能评估。结果纳入70例患者(80例冠状动脉病变)。Pd/Pa(r=0.82, p < 0.01)和cFFR (r=0.89, p < 0.01)与FFR有良好的相关性。根据建立的FFR截断阈值0.8定义阳性结果,44例(55%)病变功能显著。Pd/Pa和cFFR曲线分析显示,曲线下面积分别为0.91 (95% IC 0.85-0.98)和0.91 (95% IC 0.85-0.97)。最佳截断值为>0.92和>0.85,两者的阴性预测值分别为80%,敏感性为84%,特异性为75%和83%。结论spd /PA,尤其是cFFR对冠状动脉狭窄的功能意义预测准确。在某些情况下,这可以避免使用腺苷,节省成本和时间。