VERIFY (VERification of Instantaneous Wave-Free Ratio and Fractional Flow Reserve for the Assessment of Coronary Artery Stenosis Severity in EverydaY Practice)

BERRY, Colin, Marcel van 't VEER, Nils WITT, Petr KALA, Otakar BOČEK, Stylianos A PYXARAS, John D MCCLURE, William F FEARON, Emanuele BARBATO, Tonino A L PIM, Bernard De BRUYNE, Nico H J PIJLS a Keith G OLDROYD. VERIFY (VERification of Instantaneous Wave-Free Ratio and Fractional Flow Reserve for the Assessment of Coronary Artery Stenosis Severity in EverydaY Practice). Journal of The American College of Cardiology. USA: Elsevier Science Inc., 2013, roč. 61, č. 13, s. 1421-1427. ISSN 0735-1097. Dostupné z: https://dx.doi.org/10.1016/j.jacc.2012.09.065.

Základní údaje

• Originální název: VERIFY (VERification of Instantaneous Wave-Free Ratio and Fractional Flow Reserve for the Assessment of Coronary Artery Stenosis Severity in EverydaY Practice)
• Autoři: BERRY, Colin (826 Velká Británie a Severní Irsko), Marcel van 't VEER (528 Nizozemské království), Nils WITT (752 Švédsko), Petr KALA (203 Česká republika, garant, domácí), Otakar BOČEK (203 Česká republika), Stylianos A PYXARAS (56 Belgie), John D MCCLURE (826 Velká Británie a Severní Irsko), William F FEARON (840 Spojené státy), Emanuele BARBATO (56 Belgie), Tonino A L PIM (528 Nizozemské království), Bernard De BRUYNE (56 Belgie), Nico H J PIJLS (528 Nizozemské království) a Keith G OLDROYD (826 Velká Británie a Severní Irsko).
• Vydání: Journal of The American College of Cardiology, USA, Elsevier Science Inc. 2013, 0735-1097.

Další údaje

• Originální jazyk: angličtina
• Typ výsledku: Článek v odborném periodiku
• Obor: 30201 Cardiac and Cardiovascular systems
• Stát vydavatele: Spojené státy
• Utajení: není předmětem státního či obchodního tajemství
• Impakt faktor: Impact factor: 15.343
• Kód RIV: RIV/00216224:14110/13:00071916
• Organizační jednotka: Lékařská fakulta
• Doi: http://dx.doi.org/10.1016/j.jacc.2012.09.065
• UT WoS: 000317191200009
• Klíčová slova anglicky: adenosine; angina; FFR; hyperemia; iFR
• Příznaky: Mezinárodní význam, Recenzováno

Anotace

Objectives This study sought to compare fractional flow reserve (FFR) with the instantaneous wave-free ratio (iFR) in patients with coronary artery disease and also to determine whether the iFR is independent of hyperemia. Background FFR is a validated index of coronary stenosis severity. FFR-guided percutaneous coronary intervention (PCI) improves clinical outcomes compared to angiographic guidance alone. iFR has been proposed as a new index of stenosis severity that can be measured without adenosine. Methods We conducted a prospective, multicenter, international study of 206 consecutive patients referred for PCI and a retrospective analysis of 500 archived pressure recordings. Aortic and distal coronary pressures were measured in duplicate in patients under resting conditions and during intravenous adenosine infusion at 140 mu g/kg/min. Results Compared to the FFR cut-off value of <= 0.80, the diagnostic accuracy of the iFR value of <= 0.80 was 60% (95% confidence interval [CI]: 53% to 67%) for all vessels studied and 51% (95% CI: 43% to 59%) for those patients with FFR in the range of 0.60 to 0.90. iFR was significantly influenced by the induction of hyperemia: mean +/- SD iFR at rest was 0.82 +/- 0.16 versus 0.64 +/- 0.18 with hyperemia (p < 0.001). Receiver operating characteristics confirmed that the diagnostic accuracy of iFR was similar to resting Pd/Pa and trans-stenotic pressure gradient and significantly inferior to hyperemic iFR. Analysis of our retrospectively acquired dataset showed similar results. Conclusions iFR correlates weakly with FFR and is not independent of hyperemia. iFR cannot be recommended for clinical decision making in patients with coronary artery disease. (Comparison of Fractional Flow Reserve Versus Instant Wave-Free Ratio for Assessment of Coronary Artery Stenosis Severity in Routine Practice; NCT01559493).