Cargando…
Rate Pressure Products Affect the Relationship between the Fractional Flow Reserve and Instantaneous Wave-Free Ratio
The rate pressure product (RPP) is an index of myocardial metabolism that correlates closely with myocardial hemodynamics. The relationship between the RPP and the fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) is not known. In this study, we investigated the effects of the RP...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7396073/ https://www.ncbi.nlm.nih.gov/pubmed/32774187 http://dx.doi.org/10.1155/2020/6230153 |
_version_ | 1783565515269079040 |
---|---|
author | Ebihara, Suguru Otsuki, Hisao Arashi, Hiroyuki Yamaguchi, Junichi Hagiwara, Nobuhisa |
author_facet | Ebihara, Suguru Otsuki, Hisao Arashi, Hiroyuki Yamaguchi, Junichi Hagiwara, Nobuhisa |
author_sort | Ebihara, Suguru |
collection | PubMed |
description | The rate pressure product (RPP) is an index of myocardial metabolism that correlates closely with myocardial hemodynamics. The relationship between the RPP and the fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) is not known. In this study, we investigated the effects of the RPP on the FFR and iFR. We retrospectively enrolled 195 patients (259 lesions) who had undergone invasive coronary angiography and both the iFR and FFR examinations between 2012 and 2017. The RPP was defined as systolic blood pressure multiplied by the heart rate, measured prior to the iFR evaluation. The study population was divided into the low-RPP (n = 129, mean RPP: 6981 ± 1149) and high-RPP (n = 130, mean RPP: 10391 ± 1603) groups according to the median RPP. Correlations and biases between the iFR and FFR were compared. The diagnostic performance of the iFR in the groups was calculated, using FFR as the gold standard. The correlation between the iFR and FFR was higher in the high-RPP group than in the low-RPP group. The bias between the iFR and FFR in the high-RPP group was smaller than that in the low-RPP group. The best cutoff value of the iFR for predicting an FFR of 0.8 was 0.90 for all lesions, 0.93 for the low-RPP group, and 0.82 for the high-RPP group. The iFR and RPP showed a weak but a statistically significant negative correlation (R = 0.14; p = 0.029). This was not observed for the relationship between the FFR and RPP. In conclusion, the RPP affects the relationship between the FFR and iFR. With FFR as the gold standard, the iFR may underestimate and overestimate the functionality of ischemia in the low- and high-RPP groups, respectively. |
format | Online Article Text |
id | pubmed-7396073 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-73960732020-08-07 Rate Pressure Products Affect the Relationship between the Fractional Flow Reserve and Instantaneous Wave-Free Ratio Ebihara, Suguru Otsuki, Hisao Arashi, Hiroyuki Yamaguchi, Junichi Hagiwara, Nobuhisa J Interv Cardiol Research Article The rate pressure product (RPP) is an index of myocardial metabolism that correlates closely with myocardial hemodynamics. The relationship between the RPP and the fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) is not known. In this study, we investigated the effects of the RPP on the FFR and iFR. We retrospectively enrolled 195 patients (259 lesions) who had undergone invasive coronary angiography and both the iFR and FFR examinations between 2012 and 2017. The RPP was defined as systolic blood pressure multiplied by the heart rate, measured prior to the iFR evaluation. The study population was divided into the low-RPP (n = 129, mean RPP: 6981 ± 1149) and high-RPP (n = 130, mean RPP: 10391 ± 1603) groups according to the median RPP. Correlations and biases between the iFR and FFR were compared. The diagnostic performance of the iFR in the groups was calculated, using FFR as the gold standard. The correlation between the iFR and FFR was higher in the high-RPP group than in the low-RPP group. The bias between the iFR and FFR in the high-RPP group was smaller than that in the low-RPP group. The best cutoff value of the iFR for predicting an FFR of 0.8 was 0.90 for all lesions, 0.93 for the low-RPP group, and 0.82 for the high-RPP group. The iFR and RPP showed a weak but a statistically significant negative correlation (R = 0.14; p = 0.029). This was not observed for the relationship between the FFR and RPP. In conclusion, the RPP affects the relationship between the FFR and iFR. With FFR as the gold standard, the iFR may underestimate and overestimate the functionality of ischemia in the low- and high-RPP groups, respectively. Hindawi 2020-07-21 /pmc/articles/PMC7396073/ /pubmed/32774187 http://dx.doi.org/10.1155/2020/6230153 Text en Copyright © 2020 Suguru Ebihara et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Ebihara, Suguru Otsuki, Hisao Arashi, Hiroyuki Yamaguchi, Junichi Hagiwara, Nobuhisa Rate Pressure Products Affect the Relationship between the Fractional Flow Reserve and Instantaneous Wave-Free Ratio |
title | Rate Pressure Products Affect the Relationship between the Fractional Flow Reserve and Instantaneous Wave-Free Ratio |
title_full | Rate Pressure Products Affect the Relationship between the Fractional Flow Reserve and Instantaneous Wave-Free Ratio |
title_fullStr | Rate Pressure Products Affect the Relationship between the Fractional Flow Reserve and Instantaneous Wave-Free Ratio |
title_full_unstemmed | Rate Pressure Products Affect the Relationship between the Fractional Flow Reserve and Instantaneous Wave-Free Ratio |
title_short | Rate Pressure Products Affect the Relationship between the Fractional Flow Reserve and Instantaneous Wave-Free Ratio |
title_sort | rate pressure products affect the relationship between the fractional flow reserve and instantaneous wave-free ratio |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7396073/ https://www.ncbi.nlm.nih.gov/pubmed/32774187 http://dx.doi.org/10.1155/2020/6230153 |
work_keys_str_mv | AT ebiharasuguru ratepressureproductsaffecttherelationshipbetweenthefractionalflowreserveandinstantaneouswavefreeratio AT otsukihisao ratepressureproductsaffecttherelationshipbetweenthefractionalflowreserveandinstantaneouswavefreeratio AT arashihiroyuki ratepressureproductsaffecttherelationshipbetweenthefractionalflowreserveandinstantaneouswavefreeratio AT yamaguchijunichi ratepressureproductsaffecttherelationshipbetweenthefractionalflowreserveandinstantaneouswavefreeratio AT hagiwaranobuhisa ratepressureproductsaffecttherelationshipbetweenthefractionalflowreserveandinstantaneouswavefreeratio |