Cortés Carlos, Carrasco-Moraleja Manuel, Aparisi Alvaro, Rodriguez-Gabella Tania, Campo Alberto, Gutiérrez Hipolito, Julca Fabián, Gómez Itziar, San Román Jose Alberto, Amat-Santos Ignacio J
Department of Cardiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
Department of Cardiology, Hospital San Pedro de Logroño, Logroño, Spain.
Catheter Cardiovasc Interv. 2021 Apr 1;97(5):807-814. doi: 10.1002/ccd.28857. Epub 2020 Mar 20.
Despite of the wide evidence of use fractional flow reserve (FFR), isolated angiography evaluation is still the main tool to indicate percutaneous coronary intervention. Quantitative flow ratio (QFR) is a new functional index to assess functional significance. Recently, few studies have showed the capacity of QFR to predict significance stenosis. The aim of this research has been to describe the evidence of QFR in this clinical setting, to analyze the global diagnosis accuracy of QFR versus FFR and to compare the difference in feasibility between retrospective and prospective analysis.
Systematic review of literature was performed. Eligible studies for the meta-analysis were considered those directly evaluating de QFR versus FFR. Pooled values of diagnosis test and summary receiver operator curve were calculated. Main causes of not-perform QFR analysis according to study design were also evaluated. Sixteen studies were included. Good correlation and agreement were showed. Global sensibility, specificity, PPV, and NPV were 0.84, 0.89, 0.80, and 0.92, respectively. Then, 18% of evaluated vessels could not be analyzed. Significant differences were found in the percentage of discarded vessels and the cause of nonperformed analysis between retrospective or prospective analysis.
Excellent correlation and agreement between QFR and FFR was demonstrated. QFR assessment could be improved by its prospective analysis with a dedicated protocol.
尽管有大量证据表明分数流储备（FFR）的应用，但单纯的血管造影评估仍是指导经皮冠状动脉介入治疗的主要手段。定量血流比（QFR）是一种评估功能意义的新功能指标。最近，很少有研究显示QFR预测显著狭窄的能力。本研究的目的是描述QFR在这种临床环境中的证据，分析QFR与FFR的整体诊断准确性，并比较回顾性分析和前瞻性分析在可行性方面的差异。
进行了文献系统综述。纳入荟萃分析的合格研究为那些直接评估QFR与FFR的研究。计算了诊断试验的合并值和总结接收器操作曲线。还根据研究设计评估了未进行QFR分析的主要原因。纳入了16项研究。结果显示出良好的相关性和一致性。整体敏感性、特异性、阳性预测值和阴性预测值分别为0.84、0.89、0.80和0.92。然后，18%的评估血管无法进行分析。回顾性或前瞻性分析在废弃血管的百分比和未进行分析的原因方面存在显著差异。
QFR与FFR之间显示出极好的相关性和一致性。通过采用专门方案进行前瞻性分析可以改善QFR评估。
