Ruiko Seki MD, Damien Collison MB, BCh, MD, Kazumasa Ikeda MD, Jeroen Sonck MD, PhD, Daniel Munhoz MD, PhD, Dario Tino Bertolone MD, Brian Ko MD, PhD, Michael Maeng MD, PhD, Hiromasa Otake MD, FACC, Bon-Kon Koo MD, PhD, Tatyana Storozhenko MD, Frederic Bouisset MD, Marta Belmonte MD, Attilio Leone MD, Monika Shumkova MD, Tom J. Ford MBChB, PhD, Thabo Mahendiran BMBCh, MD, Colin Berry MBChB, PhD, Bernard De Bruyne MD, PhD, Keith Oldroyd MBChB, MD, Koshiro Sakai MD, PhD, Takuya Mizukami MD, PhD, Carlos Collet MD, PhD
{"title":"虚拟部分流量储备回撤曲线的验证。","authors":"Ruiko Seki MD, Damien Collison MB, BCh, MD, Kazumasa Ikeda MD, Jeroen Sonck MD, PhD, Daniel Munhoz MD, PhD, Dario Tino Bertolone MD, Brian Ko MD, PhD, Michael Maeng MD, PhD, Hiromasa Otake MD, FACC, Bon-Kon Koo MD, PhD, Tatyana Storozhenko MD, Frederic Bouisset MD, Marta Belmonte MD, Attilio Leone MD, Monika Shumkova MD, Tom J. Ford MBChB, PhD, Thabo Mahendiran BMBCh, MD, Colin Berry MBChB, PhD, Bernard De Bruyne MD, PhD, Keith Oldroyd MBChB, MD, Koshiro Sakai MD, PhD, Takuya Mizukami MD, PhD, Carlos Collet MD, PhD","doi":"10.1002/ccd.31222","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Angiography-derived fractional flow reserve (virtual FFR) has shown excellent diagnostic performance compared with wire-based FFR. However, virtual FFR pullback curves have not been validated yet.</p>\n </section>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>To validate the accuracy of virtual FFR pullback curves compared to wire-based FFR pullbacks and to assess their clinical utility using patient-reported outcomes.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Pooled analysis of two prospective studies, including patients with hemodynamically significant (FFR ≤ 0.80) coronary artery disease (CAD). Virtual and wire-based FFR pullbacks were compared to assess the accuracy of virtual pullbacks to characterize CAD as focal or diffuse. Pullbacks were analyzed visually and quantitatively using the pullback pressure gradient (PPG). Patients underwent PCI, and the Seattle Angina Questionnaire (SAQ) was administered at 3-month follow-up.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 298 patients (300 vessels) with both virtual and wire-based pullbacks who underwent PCI were included in the analysis. The mean age was 61.8 ± 8.8, and 15% were female. The agreement on the visual adjudication of the CAD pattern was fair (Cohen's Kappa: 0.31, 95% confidence interval: 0.18–0.45). The mean PPG were 0.65 ± 0.18 from virtual pullbacks and 0.65 ± 0.13 from wire-based pullbacks (<i>r</i> = 0.68, mean difference 0, limits of agreement −0.27 to 0.28). At follow-up, patients with high virtual PPG (>0.67) had higher SAQ angina frequency scores (i.e., less angina) than those with low virtual PPG (SAQ scores 92.0 ± 14.3 vs. 85.5 ± 23.1, <i>p</i> = 0.022).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Virtual FFR pullback curves showed moderate agreement with wire-based FFR pullbacks. Nonetheless, patients with focal disease based on virtual PPG reported greater improvement in angina after PCI.</p>\n </section>\n </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 6","pages":"1178-1188"},"PeriodicalIF":2.1000,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Validation of virtual fractional flow reserve pullback curves\",\"authors\":\"Ruiko Seki MD, Damien Collison MB, BCh, MD, Kazumasa Ikeda MD, Jeroen Sonck MD, PhD, Daniel Munhoz MD, PhD, Dario Tino Bertolone MD, Brian Ko MD, PhD, Michael Maeng MD, PhD, Hiromasa Otake MD, FACC, Bon-Kon Koo MD, PhD, Tatyana Storozhenko MD, Frederic Bouisset MD, Marta Belmonte MD, Attilio Leone MD, Monika Shumkova MD, Tom J. Ford MBChB, PhD, Thabo Mahendiran BMBCh, MD, Colin Berry MBChB, PhD, Bernard De Bruyne MD, PhD, Keith Oldroyd MBChB, MD, Koshiro Sakai MD, PhD, Takuya Mizukami MD, PhD, Carlos Collet MD, PhD\",\"doi\":\"10.1002/ccd.31222\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Angiography-derived fractional flow reserve (virtual FFR) has shown excellent diagnostic performance compared with wire-based FFR. However, virtual FFR pullback curves have not been validated yet.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>To validate the accuracy of virtual FFR pullback curves compared to wire-based FFR pullbacks and to assess their clinical utility using patient-reported outcomes.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Pooled analysis of two prospective studies, including patients with hemodynamically significant (FFR ≤ 0.80) coronary artery disease (CAD). Virtual and wire-based FFR pullbacks were compared to assess the accuracy of virtual pullbacks to characterize CAD as focal or diffuse. Pullbacks were analyzed visually and quantitatively using the pullback pressure gradient (PPG). Patients underwent PCI, and the Seattle Angina Questionnaire (SAQ) was administered at 3-month follow-up.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 298 patients (300 vessels) with both virtual and wire-based pullbacks who underwent PCI were included in the analysis. The mean age was 61.8 ± 8.8, and 15% were female. The agreement on the visual adjudication of the CAD pattern was fair (Cohen's Kappa: 0.31, 95% confidence interval: 0.18–0.45). The mean PPG were 0.65 ± 0.18 from virtual pullbacks and 0.65 ± 0.13 from wire-based pullbacks (<i>r</i> = 0.68, mean difference 0, limits of agreement −0.27 to 0.28). At follow-up, patients with high virtual PPG (>0.67) had higher SAQ angina frequency scores (i.e., less angina) than those with low virtual PPG (SAQ scores 92.0 ± 14.3 vs. 85.5 ± 23.1, <i>p</i> = 0.022).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Virtual FFR pullback curves showed moderate agreement with wire-based FFR pullbacks. 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Validation of virtual fractional flow reserve pullback curves
Background
Angiography-derived fractional flow reserve (virtual FFR) has shown excellent diagnostic performance compared with wire-based FFR. However, virtual FFR pullback curves have not been validated yet.
Objectives
To validate the accuracy of virtual FFR pullback curves compared to wire-based FFR pullbacks and to assess their clinical utility using patient-reported outcomes.
Methods
Pooled analysis of two prospective studies, including patients with hemodynamically significant (FFR ≤ 0.80) coronary artery disease (CAD). Virtual and wire-based FFR pullbacks were compared to assess the accuracy of virtual pullbacks to characterize CAD as focal or diffuse. Pullbacks were analyzed visually and quantitatively using the pullback pressure gradient (PPG). Patients underwent PCI, and the Seattle Angina Questionnaire (SAQ) was administered at 3-month follow-up.
Results
A total of 298 patients (300 vessels) with both virtual and wire-based pullbacks who underwent PCI were included in the analysis. The mean age was 61.8 ± 8.8, and 15% were female. The agreement on the visual adjudication of the CAD pattern was fair (Cohen's Kappa: 0.31, 95% confidence interval: 0.18–0.45). The mean PPG were 0.65 ± 0.18 from virtual pullbacks and 0.65 ± 0.13 from wire-based pullbacks (r = 0.68, mean difference 0, limits of agreement −0.27 to 0.28). At follow-up, patients with high virtual PPG (>0.67) had higher SAQ angina frequency scores (i.e., less angina) than those with low virtual PPG (SAQ scores 92.0 ± 14.3 vs. 85.5 ± 23.1, p = 0.022).
Conclusion
Virtual FFR pullback curves showed moderate agreement with wire-based FFR pullbacks. Nonetheless, patients with focal disease based on virtual PPG reported greater improvement in angina after PCI.
期刊介绍：
Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.
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