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Quantitative Flow Ratio Is Related to Anatomic Left Main Stem Lesion Parameters as Assessed by Intravascular Imaging

Introduction: Previously, an association between anatomic left main stem (LMS) lesion parameters, as described by intravascular ultrasound (IVUS) and fractional flow reserve (FFR), was shown. Quantitative flow ratio (QFR) is a novel, promising technique which can assess functional stenosis relevance...

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Autores principales: Milzi, Andrea, Dettori, Rosalia, Lubberich, Richard Karl, Burgmaier, Kathrin, Marx, Nikolaus, Reith, Sebastian, Burgmaier, Mathias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604622/
https://www.ncbi.nlm.nih.gov/pubmed/36294345
http://dx.doi.org/10.3390/jcm11206024
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author Milzi, Andrea
Dettori, Rosalia
Lubberich, Richard Karl
Burgmaier, Kathrin
Marx, Nikolaus
Reith, Sebastian
Burgmaier, Mathias
author_facet Milzi, Andrea
Dettori, Rosalia
Lubberich, Richard Karl
Burgmaier, Kathrin
Marx, Nikolaus
Reith, Sebastian
Burgmaier, Mathias
author_sort Milzi, Andrea
collection PubMed
description Introduction: Previously, an association between anatomic left main stem (LMS) lesion parameters, as described by intravascular ultrasound (IVUS) and fractional flow reserve (FFR), was shown. Quantitative flow ratio (QFR) is a novel, promising technique which can assess functional stenosis relevance based only on angiography. However, as little is known about the relationship between anatomic LMS parameters and QFR, it was thus investigated in this study. Methods: In 53 patients with LMS disease, we tested the association between anatomic assessment using OCT (n = 28) or IVUS (n = 25) on the one hand and functional assessment as determined by QFR on the other hand. LMS-QFR was measured using a dedicated approach, averaging QFR over left anterior descending (LAD) and circumflex (LCX) and manually limiting segment of interest to LMS. Results: The minimal luminal area of the LMS (LMS-MLA) as measured by intravascular imaging showed a consistent correlation with QFR (R = 0.61, p < 0.001). QFR could predict a LMS-MLA < 6 mm(2) with very good diagnostic accuracy (AUC 0.919) and a LMS-MLA < 4.5 mm(2) with good accuracy (AUC 0.798). Similar results were obtained for other stenosis parameters. Conclusions: QFR might be a valuable tool to assess LMS disease. Further studies focusing on patient outcomes are needed to further validate the effectiveness of this approach.
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spelling pubmed-96046222022-10-27 Quantitative Flow Ratio Is Related to Anatomic Left Main Stem Lesion Parameters as Assessed by Intravascular Imaging Milzi, Andrea Dettori, Rosalia Lubberich, Richard Karl Burgmaier, Kathrin Marx, Nikolaus Reith, Sebastian Burgmaier, Mathias J Clin Med Article Introduction: Previously, an association between anatomic left main stem (LMS) lesion parameters, as described by intravascular ultrasound (IVUS) and fractional flow reserve (FFR), was shown. Quantitative flow ratio (QFR) is a novel, promising technique which can assess functional stenosis relevance based only on angiography. However, as little is known about the relationship between anatomic LMS parameters and QFR, it was thus investigated in this study. Methods: In 53 patients with LMS disease, we tested the association between anatomic assessment using OCT (n = 28) or IVUS (n = 25) on the one hand and functional assessment as determined by QFR on the other hand. LMS-QFR was measured using a dedicated approach, averaging QFR over left anterior descending (LAD) and circumflex (LCX) and manually limiting segment of interest to LMS. Results: The minimal luminal area of the LMS (LMS-MLA) as measured by intravascular imaging showed a consistent correlation with QFR (R = 0.61, p < 0.001). QFR could predict a LMS-MLA < 6 mm(2) with very good diagnostic accuracy (AUC 0.919) and a LMS-MLA < 4.5 mm(2) with good accuracy (AUC 0.798). Similar results were obtained for other stenosis parameters. Conclusions: QFR might be a valuable tool to assess LMS disease. Further studies focusing on patient outcomes are needed to further validate the effectiveness of this approach. MDPI 2022-10-12 /pmc/articles/PMC9604622/ /pubmed/36294345 http://dx.doi.org/10.3390/jcm11206024 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Milzi, Andrea
Dettori, Rosalia
Lubberich, Richard Karl
Burgmaier, Kathrin
Marx, Nikolaus
Reith, Sebastian
Burgmaier, Mathias
Quantitative Flow Ratio Is Related to Anatomic Left Main Stem Lesion Parameters as Assessed by Intravascular Imaging
title Quantitative Flow Ratio Is Related to Anatomic Left Main Stem Lesion Parameters as Assessed by Intravascular Imaging
title_full Quantitative Flow Ratio Is Related to Anatomic Left Main Stem Lesion Parameters as Assessed by Intravascular Imaging
title_fullStr Quantitative Flow Ratio Is Related to Anatomic Left Main Stem Lesion Parameters as Assessed by Intravascular Imaging
title_full_unstemmed Quantitative Flow Ratio Is Related to Anatomic Left Main Stem Lesion Parameters as Assessed by Intravascular Imaging
title_short Quantitative Flow Ratio Is Related to Anatomic Left Main Stem Lesion Parameters as Assessed by Intravascular Imaging
title_sort quantitative flow ratio is related to anatomic left main stem lesion parameters as assessed by intravascular imaging
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604622/
https://www.ncbi.nlm.nih.gov/pubmed/36294345
http://dx.doi.org/10.3390/jcm11206024
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