Department of Cardiovascular Medicine, Wakayama Medical University.
Circ J. 2018 Feb 23;82(3):807-814. doi: 10.1253/circj.CJ-17-0949. Epub 2018 Jan 16.
A novel index of the functional severity of coronary stenosis, quantitative flow ratio (QFR), may not consider the amount of viable myocardium in prior myocardial infarction (MI) because QFR is calculated from 3D quantitative coronary angiography.Methods and Results:We analyzed QFR (fixed-flow QFR [fQFR] and contrast-flow QFR [cQFR]) and fractional flow reserve (FFR) in prior-MI-related coronary arteries (n=75) and non-prior-MI-related coronary arteries (n=75). Both fQFR and cQFR directly correlated with FFR in the prior-MI-related coronary arteries (fQFR: r=0.84, P<0.001; and cQFR: r=0.88, P<0.001) and the non-prior-MI-related coronary arteries (fQFR: r=0.91, P<0.001; and cQFR: r=0.94, P<0.001). fQFR was significantly smaller than FFR in the prior-MI-related coronary arteries (0.73±0.14 vs. 0.79±0.11, P=0.002), but there was no significant difference between fQFR and FFR in the non-prior-MI-related coronary arteries. The value of cQFR minus FFR was significantly lower in the prior-MI-related coronary arteries compared with the non-prior-MI-related coronary arteries (-0.02±0.06 vs. 0.00±0.04, P=0.010). The diagnostic accuracy of fQFR ≤0.8 and cQFR ≤0.8 for predicting FFR ≤0.80 was numerically lower in the prior-MI-related coronary arteries compared with the non-prior-MI-related coronary arteries (fQFR: 77% vs. 87%; and cQFR: 87% vs. 92%).
When FFR is used as the gold standard, the accuracy of QFR for assessing the functional severity of coronary stenosis might be reduced in the prior-MI-related coronary arteries compared with non-prior-MI-related coronary arteries.
一种新的冠状动脉狭窄功能严重程度指数，定量血流比（QFR），可能没有考虑到先前心肌梗死（MI）的存活心肌量，因为 QFR 是根据 3D 定量冠状动脉造影计算得出的。
我们分析了先前 MI 相关冠状动脉（n=75）和非先前 MI 相关冠状动脉（n=75）中的 QFR（固定流量 QFR [fQFR]和对比流量 QFR [cQFR]）和血流储备分数（FFR）。fQFR 和 cQFR 与先前 MI 相关冠状动脉的 FFR 直接相关（fQFR：r=0.84，P<0.001；cQFR：r=0.88，P<0.001）和非先前 MI 相关冠状动脉（fQFR：r=0.91，P<0.001；cQFR：r=0.94，P<0.001）。fQFR 在先前 MI 相关冠状动脉中明显小于 FFR（0.73±0.14 vs. 0.79±0.11，P=0.002），但在非先前 MI 相关冠状动脉中，fQFR 与 FFR 之间无显著差异。cQFR 减去 FFR 的差值在先前 MI 相关冠状动脉中明显低于非先前 MI 相关冠状动脉（-0.02±0.06 vs. 0.00±0.04，P=0.010）。在先前 MI 相关冠状动脉中，fQFR≤0.8 和 cQFR≤0.8 预测 FFR≤0.80 的诊断准确性低于非先前 MI 相关冠状动脉（fQFR：77% vs. 87%；cQFR：87% vs. 92%）。
当 FFR 用作金标准时，与非先前 MI 相关冠状动脉相比，QFR 评估冠状动脉狭窄功能严重程度的准确性在先前 MI 相关冠状动脉中可能降低。
