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Open Access Content loaded within last 14 days Predictive Value of Resting Pd/Pa for Fractional Flow Reserve Assessed with Monorail Pressure Microcatheter in Real-World Practice

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Background and Objectives: The aims of this study were (1) to examine the diagnostic accuracy of resting time-averaged distal coronary pressure (Pd) to mean aortic pressure (Pa) ratio to predict hyperemic fractional flow reserve (FFR) and (2) to identify a resting Pd/Pa value that can preclude the need for hyperemic FFR assessed with use of a monorail pressure catheter.

Methods: A total of 191 stenoses were assessed. After exclusions, 157 FFR data sets from 103 patients were analyzed.

Results: Resting Pd/Pa showed poor agreement with hyperemic FFR (r=0.619, P<0.001). The receiver operating characteristic curve for resting Pd/Pa with reference to hyperemic FFR of 0.80 or less showed an area under the curve of 0.800 (95% confidence interval 0.732‐0.868, P<0.001), with the greatest diagnostic accuracy of 74.5% for resting Pd/Pa of less than 0.85. Resting Pd/Pa of 0.96 or greater had a sensitivity of 100% and a negative predictive value of 100%, and resting Pd/Pa of 0.82 or less had a specificity of 98.9% and a positive predictive value of 94.1% to predict abnormal FFR of 0.80 or less. These results were consistent regardless of the vessels studied, the location of lesions, and the severity of stenosis.

Conclusions: Resting Pd/Pa showed poor agreement with hyperemic FFR assessed with use of a monorail pressure microcatheter. However, resting Pd/Pa of 0.96 or greater had excellent sensitivity and negative predictive value to predict normal hyperemic FFR, and resting Pd/Pa of 0.82 or less had excellent specificity and positive predictive value to predict abnormal hyperemic FFR.
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Keywords: fractional flow reserve; monorail pressure catheter; resting time-averaged distal coronary pressure to mean aortic pressure ratio

Document Type: Research Article

Publication date: July 1, 2019

This article was made available online on January 16, 2019 as a Fast Track article with title: "Predictive Value of Resting Pd/Pa for Fractional Flow Reserve Assessed with Monorail Pressure Microcatheter in Real-World Practice".

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  • Cardiovascular Innovations and Applications (CVIA) publishes focused articles and original clinical research that explore novel developments in cardiovascular disease, effective control and rehabilitation in cardiovascular disease, and promote cardiovascular innovations and applications for the betterment of public health globally. The journal publishes basic research that has clinical applicability in order to promote timely communication of the latest insights relating to coronary artery disease, heart failure, hypertension, cardiac arrhythmia, prevention of cardiovascular disease with a heavy emphasis on risk factor modification. Cardiovascular Innovations and Applications is the official journal of the Great Wall International Congress of Cardiology (GW-ICC). It aims to continue the work of the GW-ICC by providing a global scientific communication platform for cardiologists that bridges East and West.

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