Limits...
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 risk of drift-induced stenosis misclassification is greatest for values near the cut point: A value significantly removed from the cut point will be unlikely to be affected by drift (green arrow), whereas those close to the cut point will be more susceptible to stenosis misclassification (red arrow). FFR indicates fractional flow reserve; iFR, instantaneous wave-free ratio; PCI, percutaneous coronary intervention; and Pd/Pa, distal pressure/proximal pressure.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4836560&req=5

Figure 4: The risk of drift-induced stenosis misclassification is greatest for values near the cut point: A value significantly removed from the cut point will be unlikely to be affected by drift (green arrow), whereas those close to the cut point will be more susceptible to stenosis misclassification (red arrow). FFR indicates fractional flow reserve; iFR, instantaneous wave-free ratio; PCI, percutaneous coronary intervention; and Pd/Pa, distal pressure/proximal pressure.

Mentions: The same absolute pressure wire drift in mm Hg has the same impact on all 3 indices. Their differences in drift-induced misclassification therefore arise from the different proportion of values that lie close to the cut point (Figure 3). The further an index’s value to its cut point, the less susceptible is the lesion to misclassification from pressure wire drift. In practice, this means indices with fewer values close to the cut point will be more robust when clinically accepted levels of drift occur (Figure 4).


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 risk of drift-induced stenosis misclassification is greatest for values near the cut point: A value significantly removed from the cut point will be unlikely to be affected by drift (green arrow), whereas those close to the cut point will be more susceptible to stenosis misclassification (red arrow). FFR indicates fractional flow reserve; iFR, instantaneous wave-free ratio; PCI, percutaneous coronary intervention; and Pd/Pa, distal pressure/proximal pressure.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: The risk of drift-induced stenosis misclassification is greatest for values near the cut point: A value significantly removed from the cut point will be unlikely to be affected by drift (green arrow), whereas those close to the cut point will be more susceptible to stenosis misclassification (red arrow). FFR indicates fractional flow reserve; iFR, instantaneous wave-free ratio; PCI, percutaneous coronary intervention; and Pd/Pa, distal pressure/proximal pressure.
Mentions: The same absolute pressure wire drift in mm Hg has the same impact on all 3 indices. Their differences in drift-induced misclassification therefore arise from the different proportion of values that lie close to the cut point (Figure 3). The further an index’s value to its cut point, the less susceptible is the lesion to misclassification from pressure wire drift. In practice, this means indices with fewer values close to the cut point will be more robust when clinically accepted levels of drift occur (Figure 4).

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