Diagnostic performance and clinical implications for enhancing a hybrid quantitative flow ratio–FFR revascularization decision-making strategy

Abstract Invasive fractional flow reserve (FFR) adoption remains low mainly due to procedural and operator related factors as well as costs. Alternatively, quantitative flow ratio (QFR) achieves a high accuracy mainly outside the intermediate zone without the need for hyperaemia and wire-use. We aim...

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Autores principales:	Joyce Peper, Robbert W. van Hamersvelt, Benno J. W. M. Rensing, Jan-Peter van Kuijk, Michiel Voskuil, Jurriën M. ten Berg, Jeroen Schaap, Johannes C. Kelder, Diederick E. Grobbee, Tim Leiner, Martin J. Swaans
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ba5d4a9fa0b04779917f8b489e265037
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spelling	oai:doaj.org-article:ba5d4a9fa0b04779917f8b489e2650372021-12-02T16:31:14ZDiagnostic performance and clinical implications for enhancing a hybrid quantitative flow ratio–FFR revascularization decision-making strategy10.1038/s41598-021-85933-92045-2322https://doaj.org/article/ba5d4a9fa0b04779917f8b489e2650372021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85933-9https://doaj.org/toc/2045-2322Abstract Invasive fractional flow reserve (FFR) adoption remains low mainly due to procedural and operator related factors as well as costs. Alternatively, quantitative flow ratio (QFR) achieves a high accuracy mainly outside the intermediate zone without the need for hyperaemia and wire-use. We aimed to determine the diagnostic performance of QFR and to evaluate a QFR–FFR hybrid strategy in which FFR is measured only in the intermediate zone. This retrospective study included 289 consecutive patients who underwent invasive coronary angiography and FFR. QFR was calculated for all vessels in which FFR was measured. The QFR–FFR hybrid approach was modelled using the intermediate zone of 0.77–0.87 in which FFR-measurements are recommended. The sensitivity, specificity, and accuracy on a per vessel-based analysis were 84.6%, 86.3% and 85.6% for QFR and 88.0%, 92.9% and 90.3% for the QFR–FFR hybrid approach. The diagnostic accuracy of QFR–FFR hybrid strategy with invasive FFR measurement was 93.4% and resulted in a 56.7% reduction in the need for FFR. QFR has a good correlation and agreement with invasive FFR. A hybrid QFR–FFR approach could extend the use of QFR and reduces the proportion of invasive FFR-measurements needed while improving accuracy.Joyce PeperRobbert W. van HamersveltBenno J. W. M. RensingJan-Peter van KuijkMichiel VoskuilJurriën M. ten BergJeroen SchaapJohannes C. KelderDiederick E. GrobbeeTim LeinerMartin J. SwaansNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Joyce Peper Robbert W. van Hamersvelt Benno J. W. M. Rensing Jan-Peter van Kuijk Michiel Voskuil Jurriën M. ten Berg Jeroen Schaap Johannes C. Kelder Diederick E. Grobbee Tim Leiner Martin J. Swaans Diagnostic performance and clinical implications for enhancing a hybrid quantitative flow ratio–FFR revascularization decision-making strategy
description	Abstract Invasive fractional flow reserve (FFR) adoption remains low mainly due to procedural and operator related factors as well as costs. Alternatively, quantitative flow ratio (QFR) achieves a high accuracy mainly outside the intermediate zone without the need for hyperaemia and wire-use. We aimed to determine the diagnostic performance of QFR and to evaluate a QFR–FFR hybrid strategy in which FFR is measured only in the intermediate zone. This retrospective study included 289 consecutive patients who underwent invasive coronary angiography and FFR. QFR was calculated for all vessels in which FFR was measured. The QFR–FFR hybrid approach was modelled using the intermediate zone of 0.77–0.87 in which FFR-measurements are recommended. The sensitivity, specificity, and accuracy on a per vessel-based analysis were 84.6%, 86.3% and 85.6% for QFR and 88.0%, 92.9% and 90.3% for the QFR–FFR hybrid approach. The diagnostic accuracy of QFR–FFR hybrid strategy with invasive FFR measurement was 93.4% and resulted in a 56.7% reduction in the need for FFR. QFR has a good correlation and agreement with invasive FFR. A hybrid QFR–FFR approach could extend the use of QFR and reduces the proportion of invasive FFR-measurements needed while improving accuracy.
format	article
author	Joyce Peper Robbert W. van Hamersvelt Benno J. W. M. Rensing Jan-Peter van Kuijk Michiel Voskuil Jurriën M. ten Berg Jeroen Schaap Johannes C. Kelder Diederick E. Grobbee Tim Leiner Martin J. Swaans
author_facet	Joyce Peper Robbert W. van Hamersvelt Benno J. W. M. Rensing Jan-Peter van Kuijk Michiel Voskuil Jurriën M. ten Berg Jeroen Schaap Johannes C. Kelder Diederick E. Grobbee Tim Leiner Martin J. Swaans
author_sort	Joyce Peper
title	Diagnostic performance and clinical implications for enhancing a hybrid quantitative flow ratio–FFR revascularization decision-making strategy
title_short	Diagnostic performance and clinical implications for enhancing a hybrid quantitative flow ratio–FFR revascularization decision-making strategy
title_full	Diagnostic performance and clinical implications for enhancing a hybrid quantitative flow ratio–FFR revascularization decision-making strategy
title_fullStr	Diagnostic performance and clinical implications for enhancing a hybrid quantitative flow ratio–FFR revascularization decision-making strategy
title_full_unstemmed	Diagnostic performance and clinical implications for enhancing a hybrid quantitative flow ratio–FFR revascularization decision-making strategy
title_sort	diagnostic performance and clinical implications for enhancing a hybrid quantitative flow ratio–ffr revascularization decision-making strategy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/ba5d4a9fa0b04779917f8b489e265037
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Diagnostic performance and clinical implications for enhancing a hybrid quantitative flow ratio–FFR revascularization decision-making strategy

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