Abstract
Background The saline-induced distal coronary pressure/aortic pressure ratio predicted fractional flow reserve (FFR). The resting full-cycle ratio (RFR) represents the maximal relative pressure difference in a cardiac cycle. Therefore, the present study aimed to compare the results of saline-induced RFR (sRFR) with FFR. Methods Seventy consecutive lesions with only moderate stenosis were included. The FFR, RFR, and sRFR values were compared. The sRFR was assessed using an intracoronary bolus infusion of saline (2 mL/s) for five heartbeats. The FFR was obtained after an intravenous injection of papaverine. Results Overall, the FFR, sRFR, and RFR values were 0.78 ± 0.12, 0.79 ± 0.13, and 0.83 ± 0.14, respectively. With regard to anatomical morphology were 40, 18, and 12 cases of focal, diffuse, and tandem lesion. There was a significant correlation between the sRFR and FFR (R = 0.96, p < 0.01). There were also significant correlations between the sRFR and FFR in the left coronary and right coronary artery (R = 0.95, p < 0.01 and R = 0.98, p < 0.01). Furthermore, significant correlations between sRFR and FFR were observed in not only focal but also in nonfocal lesion including tandem and diffuse lesions (R = 0.93, p < 0.01 and R = 0.97, p < 0.01). A close agreement on FFR and sRFR was shown using the Bland–Altman analysis (95% CI of agreement: −0.08–0.07). In the receiver operating characteristic curve analysis, the cutoff value of sRFR to predict an FFR of 0.80 was 0.81 (area under curve, 0.97; sensitivity 90.6%; and specificity 98.2%). Conclusion The sRFR can accurately and safely predict the FFR and might be effective for diagnosing ischemia.
Highlights
It remains unclear whether saline-induced resting full-cycle ratio (RFR) can predict fractional flow reserve (FFR). erefore, the present study aimed to compare the results of saline-induced RFR with FFR
Seventy consecutive cardiac lesions with more than moderate stenosis based on visual estimation by coronary angiography were included in this study. e FFR, RFR, and saline-induced RFR (sRFR) were measured to identify functionally significant stenosis
MN, USA), the wire was advanced into the site distal to the stenosis. e study procedure was as follows: First, the RFR was automatically measured at resting status twice. e mean of the two values was adopted as the RFR value
Summary
Seventy consecutive cardiac lesions with more than moderate stenosis (exceeding 30%) based on visual estimation by coronary angiography were included in this study. E FFR, RFR, and sRFR were measured to identify functionally significant stenosis. We intravenously administered 100 IU/kg of heparin before coronary angiography was performed. E study procedure was as follows: First, the RFR was automatically measured at resting status twice. After the RFR measurement, the sRFR was assessed by an intracoronary bolus of saline at room temperature at 2 mL/second for 5 heartbeats through the catheter using a. E correlations between 2 factors among sRFR, RFR, Pd/Pa, and FFR values were evaluated using the Spearman rank correlation coefficient. The receiver operating characteristic (ROC) curve analysis was used to identify the sRFR cutoff value for predicting an FFR value ≤0.80. A twosided p value
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