Dobrolińska Magdalena M, Gąsior Paweł M, Pociask Elżbieta, Smolka Grzegorz, Ochala Andrzej, Wojakowski Wojciech, Roleder Tomasz
Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-635 Katowice, Poland.
Department of Biocybernetics and Biomedical Engineering, AGH University of Science and Technology, 30-059 Krakow, Poland.
Diagnostics (Basel). 2021 Jun 23;11(7):1148. doi: 10.3390/diagnostics11071148.
Quantitative flow ratio (QFR) is a new opportunity to analyze functional stenosis during invasive coronary angiography. Together with a well-known intravascular ultrasound (IVUS) and a new player in the field, near-infrared spectroscopy (NIRS), it is gaining a lot of interest. The aim of the study was to compare QFR results with integrated IVUS-NIRS results acquired simultaneously in the same coronary lesion. We retrospectively enrolled 66 patients in whom 66 coronary lesions were assessed by NIRS-IVUS and QFR. Lesions were divided into two groups based on QFR results as QFR-positive group (QFR ≤ 0.8) or QFR-negative group (QFR > 0.8). Based on ROC curve analysis, the best cut-off values of minimal lumen area (MLA), minimal lumen diameter (MLD) and percent diameter stenosis for predicting QFR ≤ 80 were 2.4 (AUC 0.733, 95%CI 0.61, 0.834), 1.6 (AUC 0.768, 95%CI 0.634, 0.872) and 59.5 (AUC 0.918, 95%CI 0.824, 0.971), respectively. In QFR-positive lesions, the maxLCBI was significantly higher than in QFR-negative lesions (450.12 ± 251.0 vs. 329.47 ± 191.14, = 0.046). The major finding of the present study is that values of IVUS-MLA, IVUS-MLD and percent diameter stenosis show a good efficiency in predicting QFR ≤ 0.80. Moreover, QFR-positive lesions are characterized by higher maxLCBI as compared to the QFR-negative group.
定量血流比（QFR）是在有创冠状动脉造影期间分析功能性狭窄的新方法。它与广为人知的血管内超声（IVUS）以及该领域的新成员近红外光谱（NIRS）一起，正引起广泛关注。本研究的目的是比较QFR结果与在同一冠状动脉病变中同时获取的IVUS-NIRS综合结果。我们回顾性纳入了66例患者，对其66处冠状动脉病变进行了NIRS-IVUS和QFR评估。根据QFR结果将病变分为两组，即QFR阳性组（QFR≤0.8）和QFR阴性组（QFR>0.8）。基于ROC曲线分析，预测QFR≤80的最小管腔面积（MLA）、最小管腔直径（MLD）和直径狭窄百分比的最佳截断值分别为2.4（AUC 0.733，95%CI 0.61，0.834）、1.6（AUC 0.768，95%CI 0.634，0.872）和59.5（AUC 0.918，95%CI 0.824，0.971）。在QFR阳性病变中，最大脂质核心负担指数（maxLCBI）显著高于QFR阴性病变（450.12±251.0对329.47±191.14，P=0.046）。本研究的主要发现是，IVUS-MLA、IVUS-MLD和直径狭窄百分比的值在预测QFR≤0.80方面显示出良好的效能。此外，与QFR阴性组相比，QFR阳性病变的特征是maxLCBI更高。
