The effects of cardiac structure, valvular regurgitation, and left ventricular diastolic dysfunction on the diagnostic accuracy of Murray law–based quantitative flow ratio

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Junqing Yang¹  Nianjin Xie¹  Yuming Huang²  Qianjun Jia²  Meiping Huang²  Huiliang Deng²  Xiaoshan Li³  Hongwen Fei³ 

[1] Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China;Department of Catheterization Lab, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China;Guangdong Medical University, Zhanjiang, China;Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China;

关键词: coronary hemodynamics;    coronary heart disease;    echocardiography;    fractional flow reserve;    quantitative flow ratio;   

DOI  :  10.3389/fcvm.2023.1134623

 received in 2022-12-30, accepted in 2023-05-08,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveThe study aimed to investigate the diagnostic accuracy of Murray law–based quantitative flow ratio (μQFR) from a single angiographic view in patients with abnormal cardiac structure, left ventricular diastolic dysfunction, and valvular regurgitation.BackgroundμQFR is a novel fluid dynamics method for deriving fractional flow reserve (FFR). In addition, current studies of μQFR mainly analyzed patients with normal cardiac structure and function. The accuracy of μQFR when patients had abnormal cardiac structure, left ventricular diastolic dysfunction, and valvular regurgitation has not been clear.MethodsThis study retrospectively analyzed 261 patients with 286 vessels that underwent both FFR and μQFR prior to intervention. The cardiac structure and function were measured using echocardiography. Pressure wire–derived FFR ≤0.80 was defined as hemodynamically significant coronary stenosis.ResultsμQFR had a moderate correlation with FFR (r = 0.73, p < 0.001), and the Bland–Altman plot presented no difference between the μQFR and FFR (0.006 ± 0.075, p = 0.192). With FFR as the standard, the diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of μQFR were 94.06% (90.65–96.50), 82.56% (72.87–89.90), 99.00% (96.44–99.88), 97.26 (89.91–99.30), and 92.96% (89.29–95.44), respectively. The concordance of μQFR/FFR was not associated with abnormal cardiac structure, valvular regurgitation (aortic valve, mitral valve, and tricuspid valve), and left ventricular diastolic function. Coronary hemodynamics showed no difference between normality and abnormality of cardiac structure and left ventricular diastolic function. Coronary hemodynamics demonstrated no difference among valvular regurgitation (none, mild, moderate, or severe).ConclusionμQFR showed an excellent agreement with FFR. The effect of abnormal cardiac structure, valvular regurgitation, and left ventricular diastolic function did not correlate with the diagnostic accuracy of μQFR. Coronary hemodynamics showed no difference in patients with abnormal cardiac structure, valvular regurgitation, and left ventricular diastolic function.

【 授权许可】

Unknown   
© 2023 Yang, Huang, Li, Jia, Deng, Xie, Huang and Fei.