Resting Full-Cycle Ratio versus Fractional Flow Reserve: A SWEDEHEART-Registry-Based Comparison of Two Physiological Indexes for Assessing Coronary Stenosis Severity
The adenosine-requiring physiological index fractional flow reserve (FFR) is the gold-standard method for determining the significance of intermediate lesions, while the resting full-cycle ratio (RFR) is a novel nonhyperaemic index without the need for adenosine administration. The aim of this study...
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Wiley
2023-01-01
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| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2023/6461691 |
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| author | Stephen Malmberg Jörg Lauermann Patric Karlström Dario Gulin Neshro Barmano |
| author_facet | Stephen Malmberg Jörg Lauermann Patric Karlström Dario Gulin Neshro Barmano |
| author_sort | Stephen Malmberg |
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| description | The adenosine-requiring physiological index fractional flow reserve (FFR) is the gold-standard method for determining the significance of intermediate lesions, while the resting full-cycle ratio (RFR) is a novel nonhyperaemic index without the need for adenosine administration. The aim of this study was to investigate the degree of concordance between RFR and FFR in indicating the need for revascularisation in patients with intermediate coronary lesions. This was a retrospective, registry-based study utilising data from the SWEDEHEART registry. Patients treated at Ryhov County Hospital in Jönköping, Sweden, between the 1st of January 2020 and the 30th of September 2021, were included. The degree of correlation and concordance between RFR and FFR was determined, both when used with a single cut-off (significant stenosis if RFR ≤0.89) and with a hybrid approach (significant stenosis if RFR ≤0.85, not significant if RFR ≥0.94, and FFR measurement when RFR was in the grey zone 0.86–0.93). The study population consisted of 143 patients with 200 lesions. The overall correlation between FFR and RFR was significant (r = 0.715, R2 = 0.511, p≤0.01). A strong correlation was seen for lesions in the left anterior descending artery (LAD) and the left circumflex artery (LCX) (r = 0.748 and 0.742, respectively, both p≤0.01), while the correlation in the right coronary artery (RCA) was moderate (r = 0.524, p≤0.01). The overall concordance between FFR and RFR using a single cut-off was 79.0%. With a hybrid cut-off approach, the degree of concordance was 91%, with no need of adenosine in 50.5% of the lesions. In conclusion, there was a strong correlation and a high degree of concordance between FFR and RFR in determining the significance of a stenosis. The use of a hybrid approach could improve the identification of physiologically significant stenoses while minimising the use of adenosine. |
| format | Article |
| id | doaj-art-095e6060147b47f2baec7ca074b31396 |
| institution | Kabale University |
| issn | 1540-8183 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-095e6060147b47f2baec7ca074b313962025-02-03T06:42:56ZengWileyJournal of Interventional Cardiology1540-81832023-01-01202310.1155/2023/6461691Resting Full-Cycle Ratio versus Fractional Flow Reserve: A SWEDEHEART-Registry-Based Comparison of Two Physiological Indexes for Assessing Coronary Stenosis SeverityStephen Malmberg0Jörg Lauermann1Patric Karlström2Dario Gulin3Neshro Barmano4Department of HealthDepartment of Internal MedicineDepartment of HealthDepartment of Internal MedicineDepartment of HealthThe adenosine-requiring physiological index fractional flow reserve (FFR) is the gold-standard method for determining the significance of intermediate lesions, while the resting full-cycle ratio (RFR) is a novel nonhyperaemic index without the need for adenosine administration. The aim of this study was to investigate the degree of concordance between RFR and FFR in indicating the need for revascularisation in patients with intermediate coronary lesions. This was a retrospective, registry-based study utilising data from the SWEDEHEART registry. Patients treated at Ryhov County Hospital in Jönköping, Sweden, between the 1st of January 2020 and the 30th of September 2021, were included. The degree of correlation and concordance between RFR and FFR was determined, both when used with a single cut-off (significant stenosis if RFR ≤0.89) and with a hybrid approach (significant stenosis if RFR ≤0.85, not significant if RFR ≥0.94, and FFR measurement when RFR was in the grey zone 0.86–0.93). The study population consisted of 143 patients with 200 lesions. The overall correlation between FFR and RFR was significant (r = 0.715, R2 = 0.511, p≤0.01). A strong correlation was seen for lesions in the left anterior descending artery (LAD) and the left circumflex artery (LCX) (r = 0.748 and 0.742, respectively, both p≤0.01), while the correlation in the right coronary artery (RCA) was moderate (r = 0.524, p≤0.01). The overall concordance between FFR and RFR using a single cut-off was 79.0%. With a hybrid cut-off approach, the degree of concordance was 91%, with no need of adenosine in 50.5% of the lesions. In conclusion, there was a strong correlation and a high degree of concordance between FFR and RFR in determining the significance of a stenosis. The use of a hybrid approach could improve the identification of physiologically significant stenoses while minimising the use of adenosine.http://dx.doi.org/10.1155/2023/6461691 |
| spellingShingle | Stephen Malmberg Jörg Lauermann Patric Karlström Dario Gulin Neshro Barmano Resting Full-Cycle Ratio versus Fractional Flow Reserve: A SWEDEHEART-Registry-Based Comparison of Two Physiological Indexes for Assessing Coronary Stenosis Severity Journal of Interventional Cardiology |
| title | Resting Full-Cycle Ratio versus Fractional Flow Reserve: A SWEDEHEART-Registry-Based Comparison of Two Physiological Indexes for Assessing Coronary Stenosis Severity |
| title_full | Resting Full-Cycle Ratio versus Fractional Flow Reserve: A SWEDEHEART-Registry-Based Comparison of Two Physiological Indexes for Assessing Coronary Stenosis Severity |
| title_fullStr | Resting Full-Cycle Ratio versus Fractional Flow Reserve: A SWEDEHEART-Registry-Based Comparison of Two Physiological Indexes for Assessing Coronary Stenosis Severity |
| title_full_unstemmed | Resting Full-Cycle Ratio versus Fractional Flow Reserve: A SWEDEHEART-Registry-Based Comparison of Two Physiological Indexes for Assessing Coronary Stenosis Severity |
| title_short | Resting Full-Cycle Ratio versus Fractional Flow Reserve: A SWEDEHEART-Registry-Based Comparison of Two Physiological Indexes for Assessing Coronary Stenosis Severity |
| title_sort | resting full cycle ratio versus fractional flow reserve a swedeheart registry based comparison of two physiological indexes for assessing coronary stenosis severity |
| url | http://dx.doi.org/10.1155/2023/6461691 |
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