Published in:
05-02-2022 | Angiography | Original Paper
Diagnostic agreement of quantitative flow ratio with fractional flow reserve in a Latin-American population
Authors:
Mauro Echavarría-Pinto, Tim P. Van de Hoef, Nancy Pacheco-Beltran, Jesus Eduardo Reyes-Carrera, Eduardo Rangel-Alvarado, Elizabeth Ledezma-Ledezma, Laura Alicia Aguilar-Castillo, Andrea Itzel Tovar-Becerra, Juan Ernesto Muñoz Arellano, María Neftalí Maqueda Ramírez, Miriam Muruaga, Ana Maria Ibarra-Rangel, Carlos Alberto Montes-Collantes, Jorge Luis Castrejon-Mora, Irma Hualtal Chong-Benitez, Luis Homero Vargas-Torrrescano, Hector M. García-García
Published in:
The International Journal of Cardiovascular Imaging
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Issue 7/2022
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Abstract
Quantitative flow ratio (QFR) is a recently proposed angiographic index that allows to assess the pressure loss in coronary arteries in a similar fashion as the fractional flow reserve (FFR). The purpose of this study was to evaluate the diagnostic performance of QFR as compared to FFR, in a Latin-American population of patients with suspected ischaemic heart disease. QFR was retrospectively derived from coronary angiograms. The association, diagnostic performance, and continuous agreement of fixed-flow QFR (fQFR) and contrast-flow QFR (cQFR) with FFR was assessed by continuous and dichotomous methods. 90 vessels form 66 patients were finally included. The study comprised coronary stenoses of intermediate severity, both angiographically (diameter stenosis: 46.6 ± 12.8%) and physiologically [median FFR = 0.83 (quartile 1–3, 0.76–0.89)]. The correlation of FFR with both fQFR [ρ = 0.841, (95% CI 0.767 to 0.893), p < 0.001] and cQFR [ρ = 0.833, (95% CI 0.755 to 0.887), p < 0.001] was strong. The diagnostic performance of cQFR was good [area under the ROC curve of 0.92 (95% CI 0.86 to 0.97, p < 0.001)], with 0.80 as the optimal cQFR cut-off against FFR ≤ 0.80. This 0.80 cQFR cut-off classified correctly 83.3% of total stenoses, with a sensitivity of 85.2% and specificity of 80.6%. QFR was strongly associated with FFR and exhibited a high diagnostic performance in this Latin-American population.