Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Catheter Cardiovasc Interv. 2022 May;99 Suppl 1:1403-1409. doi: 10.1002/ccd.30078. Epub 2022 Feb 7.
We compared the diagnostic performance of the ultrasonic flow ratio (UFR) and quantitative flow ratio (QFR) for left main coronary artery (LMCA) stenosis.
Evaluation of LMCA stenosis remains challenging because of its complex pathogenesis and severity. Computing QFR allows rapid determination of fractional flow reserve (FFR) from coronary angiograms. A novel intravascular ultrasound (IVUS)-based FFR (UFR) allows rapid FFR computation from IVUS images. Neither of the computational approaches required a pressure wire or hyperemia induction. Previous studies have validated the good diagnostic accuracy of QFR and UFR in identifying hemodynamically significant coronary stenosis using FFR as the reference standard.
This retrospective observational study enrolled consecutive patients with intermediate-grade LMCA stenosis who underwent IVUS evaluation. UFR and QFR of all LMCA stenosis patients were assessed, their correlation and agreement were analyzed, and diagnostic performance of UFR in LMCA stenosis was evaluated.
Eighty-three paired comparisons between UFR and QFR were obtained. UFR excellently correlated with QFR (r = 0.74, p < 0.01). The Bland-Altman plot showed good agreement between UFR and QFR (mean differences: 0.01 ± 0.05, p = 0.34). The area under the curve of UFR for identifying physiological LMCA stenosis was 0.97 (95% confidence interval [CI]: 0.93-1.00, p < 0.01). The overall UFR diagnostic accuracy was 0.95 (95% CI: 0.88-0.99).
UFR showed excellent correlation and good agreement with QFR in LMCA stenosis assessment, indicating that it is highly feasible to use UFR for functional evaluation of LMCA stenosis.
我们比较了超声流量比（UFR）和定量流量比（QFR）在左主干冠状动脉（LMCA）狭窄中的诊断性能。
由于 LMCA 狭窄的复杂发病机制和严重程度，其评估仍然具有挑战性。计算 QFR 允许从冠状动脉造影快速确定血流储备分数（FFR）。一种新的基于血管内超声（IVUS）的 FFR（UFR）允许从 IVUS 图像快速计算 FFR。这两种计算方法都不需要压力导丝或诱导充血。先前的研究已经验证了 QFR 和 UFR 在使用 FFR 作为参考标准识别有血流动力学意义的冠状动脉狭窄方面具有良好的诊断准确性。
这项回顾性观察性研究纳入了接受 IVUS 评估的有中度 LMCA 狭窄的连续患者。评估了所有 LMCA 狭窄患者的 UFR 和 QFR，并分析了它们之间的相关性和一致性，评估了 UFR 在 LMCA 狭窄中的诊断性能。
获得了 83 对 UFR 和 QFR 之间的比较。UFR 与 QFR 具有极好的相关性（r=0.74，p<0.01）。Bland-Altman 图显示 UFR 和 QFR 之间具有良好的一致性（平均差异：0.01±0.05，p=0.34）。UFR 用于识别生理性 LMCA 狭窄的曲线下面积为 0.97（95%置信区间：0.93-1.00，p<0.01）。总体 UFR 诊断准确性为 0.95（95%置信区间：0.88-0.99）。
UFR 在 LMCA 狭窄评估中与 QFR 显示出极好的相关性和良好的一致性，表明使用 UFR 进行 LMCA 狭窄的功能评估是高度可行的。
