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Quantification of the Effect of Pressure Wire Drift on the Diagnostic Performance of Fractional Flow Reserve, Instantaneous Wave-Free Ratio, and Whole-Cycle Pd/Pa.

Cook CM, Ahmad Y, Shun-Shin MJ, Nijjer S, Petraco R, Al-Lamee R, Mayet J, Francis DP, Sen S, Davies JE - Circ Cardiovasc Interv (2016)

Bottom Line: Both FFR and iFR had significantly lower misclassification than whole-cycle Pd/Pa (P<0.001).There was no statistically significant difference between the diagnostic performance of FFR and iFR (P=0.125).Whole-cycle Pd/Pa is more vulnerable to such reclassification than FFR and iFR.

View Article: PubMed Central - PubMed

Affiliation: From the International Centre for Circulatory Health, National Heart & Lung Institute, Imperial College NHS Trust, United Kingdom. christopher.cook@nhs.net.

No MeSH data available.


Related in: MedlinePlus

The distribution of values for fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), and whole-cycle distal pressure/proximal pressure (Pd/Pa): density plots show the differing distribution of values with FFR, iFR, and whole-cycle Pd/Pa values for the same 447 stenoses. Solid black lines indicate the cut point value. The highlighted regions indicate values within ±0.05 U of the cut point; 34.6% (155), 50.1% (224), and 62.2% (278) of values lay within ±0.05 U of the cut point for FFR, iFR, and whole-cycle Pd/Pa, respectively.
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Figure 3: The distribution of values for fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), and whole-cycle distal pressure/proximal pressure (Pd/Pa): density plots show the differing distribution of values with FFR, iFR, and whole-cycle Pd/Pa values for the same 447 stenoses. Solid black lines indicate the cut point value. The highlighted regions indicate values within ±0.05 U of the cut point; 34.6% (155), 50.1% (224), and 62.2% (278) of values lay within ±0.05 U of the cut point for FFR, iFR, and whole-cycle Pd/Pa, respectively.

Mentions: The distribution of FFR, iFR, and resting whole-cycle Pd/Pa values were all significantly deviated from normality (P<0.001 for all 3 indices), with significant negative skew (P<0.001 for all three indices). For the same population of stenoses, the dynamic range of values for each pressure-only index was different. This can be expressed as a range of values or by the number of 0.01 U spanned. iFR had the largest dynamic range of values (0.39–1.0, a 62 U spread), compared with FFR (95% range: 0.43–0.97, a 55 U spread) and resting whole-cycle Pd/Pa (95% range: 0.59–1.0, a 41 U spread; P<0.001 for all comparisons; Figure 3).


Quantification of the Effect of Pressure Wire Drift on the Diagnostic Performance of Fractional Flow Reserve, Instantaneous Wave-Free Ratio, and Whole-Cycle Pd/Pa.

Cook CM, Ahmad Y, Shun-Shin MJ, Nijjer S, Petraco R, Al-Lamee R, Mayet J, Francis DP, Sen S, Davies JE - Circ Cardiovasc Interv (2016)

The distribution of values for fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), and whole-cycle distal pressure/proximal pressure (Pd/Pa): density plots show the differing distribution of values with FFR, iFR, and whole-cycle Pd/Pa values for the same 447 stenoses. Solid black lines indicate the cut point value. The highlighted regions indicate values within ±0.05 U of the cut point; 34.6% (155), 50.1% (224), and 62.2% (278) of values lay within ±0.05 U of the cut point for FFR, iFR, and whole-cycle Pd/Pa, respectively.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4836560&req=5

Figure 3: The distribution of values for fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), and whole-cycle distal pressure/proximal pressure (Pd/Pa): density plots show the differing distribution of values with FFR, iFR, and whole-cycle Pd/Pa values for the same 447 stenoses. Solid black lines indicate the cut point value. The highlighted regions indicate values within ±0.05 U of the cut point; 34.6% (155), 50.1% (224), and 62.2% (278) of values lay within ±0.05 U of the cut point for FFR, iFR, and whole-cycle Pd/Pa, respectively.
Mentions: The distribution of FFR, iFR, and resting whole-cycle Pd/Pa values were all significantly deviated from normality (P<0.001 for all 3 indices), with significant negative skew (P<0.001 for all three indices). For the same population of stenoses, the dynamic range of values for each pressure-only index was different. This can be expressed as a range of values or by the number of 0.01 U spanned. iFR had the largest dynamic range of values (0.39–1.0, a 62 U spread), compared with FFR (95% range: 0.43–0.97, a 55 U spread) and resting whole-cycle Pd/Pa (95% range: 0.59–1.0, a 41 U spread; P<0.001 for all comparisons; Figure 3).

Bottom Line: Both FFR and iFR had significantly lower misclassification than whole-cycle Pd/Pa (P<0.001).There was no statistically significant difference between the diagnostic performance of FFR and iFR (P=0.125).Whole-cycle Pd/Pa is more vulnerable to such reclassification than FFR and iFR.

View Article: PubMed Central - PubMed

Affiliation: From the International Centre for Circulatory Health, National Heart & Lung Institute, Imperial College NHS Trust, United Kingdom. christopher.cook@nhs.net.

No MeSH data available.


Related in: MedlinePlus