Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 310016 Hangzhou, Zhejiang, China.
Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, 310016 Hangzhou, Zhejiang, China.
Rev Cardiovasc Med. 2022 Feb 12;23(2):59. doi: 10.31083/j.rcm2302059.
Quantitative flow ratio (QFR) is a novel angiography derived fractional flow reserve (FFR) technique. However, its diagnostic accuracy has only be validated in native coronary lesions but not in vessels after bioresorbable scaffold (BRS) implantation. This study aims to evaluate the diagnostic accuracy of residual QFR in coronary vessels immediately post-BRS implantation.
This is a retrospective, two center, validation cohort study. 73 stable angina patients who received at least one lesion of an everolimus eluting stent (EES)/BRS implantation with subsequent residual FFR assessment were screened. Patients with aorta-ostial stenoses, bridge vessels at the distal segment of targeted vessels, acute coronary syndrome, previous coronary artery bypass grafting, age <18 years, lack of ≥2 final angiographic projections were excluded. Contrast QFR assessment was performed blinded to FFR assessment.
A good correlation (r = 0.680, < 0.001) was found between residual QFR and FFR. In the EES implantation cohort, a good correlation (r = 0.769, < 0.001) was found between residual QFR and FFR, and a moderate correlation (r = 0.446, = 0.038) in the BRS cohort. The area under the Receiver operator characteristic (ROC) curve for detecting FFR ≤0.86 was 0.883 for all patients.
Residual QFR assessment after BRS implantation is feasible, and has a moderate correlation and agreement with residual FFR. QFR may be a promising tool similar to FFR to evaluate post-BRS effect.
定量血流比（QFR）是一种新的血管造影衍生的血流储备分数（FFR）技术。然而，其诊断准确性仅在原生冠状动脉病变中得到验证，而不在生物可吸收支架（BRS）植入后的血管中得到验证。本研究旨在评估即刻植入 BRS 后冠状动脉残余 QFR 的诊断准确性。
这是一项回顾性的、双中心的验证队列研究。筛选了 73 例稳定型心绞痛患者，这些患者至少接受了一次雷帕霉素洗脱支架（EES）/BRS 植入术，并随后进行了残余 FFR 评估。排除了主动脉-开口狭窄、靶血管远端桥血管、急性冠脉综合征、既往冠状动脉旁路移植术、年龄<18 岁、缺乏≥2 个最终血管造影投影的患者。对比 QFR 评估是在对 FFR 评估不知情的情况下进行的。
残余 QFR 与 FFR 之间存在良好的相关性（r=0.680，<0.001）。在 EES 植入组中，残余 QFR 与 FFR 之间存在良好的相关性（r=0.769，<0.001），在 BRS 组中存在中度相关性（r=0.446，=0.038）。所有患者检测 FFR≤0.86 的受试者工作特征（ROC）曲线下面积为 0.883。
BRS 植入后残余 QFR 评估是可行的，与残余 FFR 具有中度相关性和一致性。QFR 可能是一种有前途的工具，类似于 FFR，用于评估 BRS 植入后的效果。
