Fractional Flow Reserve Versus Instantaneous Wave-Free Ratio in
Assessment of Lesion Hemodynamic Significance and Explanation
of their Discrepancies. International, Multicenter and
Prospective Trial: The FiGARO Study

J 2022

Fractional Flow Reserve Versus Instantaneous Wave-Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study

KOVARNIK, Tomas, Matsuo HITOSHI, Ales KRAL, Stepan JERABEK, David ZEMANEK et. al.

Basic information

Original name

Fractional Flow Reserve Versus Instantaneous Wave-Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study

Authors

KOVARNIK, Tomas (203 Czech Republic, guarantor), Matsuo HITOSHI, Ales KRAL (203 Czech Republic), Stepan JERABEK (203 Czech Republic), David ZEMANEK (203 Czech Republic), Yoshiaki KAWASE, Hiroyuki OMORI, Toru TANIGAKI, Jan PUDIL (203 Czech Republic), Alexandra VODZINSKA (203 Czech Republic), Marian BRANNY (203 Czech Republic), Roman ŠTÍPAL (203 Czech Republic, belonging to the institution), Petr KALA (203 Czech Republic, belonging to the institution), Jan MROZEK (203 Czech Republic), Martin PORZER (203 Czech Republic), Tomas GREZL (203 Czech Republic), Kamil NOVOBILSKY (203 Czech Republic), Oscar MENDIZ (203 Czech Republic), Karel KOPRIVA (203 Czech Republic), Martin MATES (203 Czech Republic), Martin CHVAL (203 Czech Republic), Zhi CHEN, Pavel MARTASEK (203 Czech Republic) and Ales LINHART (203 Czech Republic)

Edition

Journal of the American Heart Association, Hoboken, Wiley-Blackwell, 2022, 2047-9980

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 5.400

RIV identification code

RIV/00216224:14110/22:00129589

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1161/JAHA.121.021490

UT WoS

000789861900023

Keywords in English

coronary flow reserve; fractional flow reserve; instantaneous wave-free ratio

Abstract

V originále

Background:The FiGARO (FFR versus iFR in Assessment of Hemodynamic Lesion Significance, and an Explanation of Their Discrepancies) trial is a prospective registry searching for predictors of fractional flow reserve/instantaneous wave-free ratio (FFR/iFR) discrepancy. Methods and Results:FFR/iFR were analyzed using a Verrata wire, and coronary flow reserve was analyzed using a Combomap machine (both Philips-Volcano). The risk polymorphisms for endothelial nitric oxide synthase and for heme oxygenase-1 were analyzed. In total, 1884 FFR/iFR measurements from 1564 patients were included. The FFR/iFR discrepancy occurred in 393 measurements (20.9%): FFRp (positive)/iFRn (negative) type (264 lesions, 14.0%) and FFRn/iFRp (129 lesions, 6.8%) type. Coronary flow reserve was measured in 343 lesions, correlating better with iFR (R=0.56, P<0.0001) than FFR (R=0.36, P<0.0001). The coronary flow reserve value in FFRp/iFRn lesions (2.24 +/- 0.7) was significantly higher compared with both FFRp/iFRp (1.39 +/- 0.36), and FFRn/iFRn lesions (1.8 +/- 0.64, P<0.0001). Multivariable logistic regression analysis confirmed (1) sex, age, and lesion location in the right coronary artery as predictors for FFRp/iFRn discrepancy; and (2) hemoglobin level, smoking, and renal insufficiency as predictors for FFRn/iFRp discrepancy. The FFRn/iFRp type of discrepancy was significantly more frequent in patients with both risk types of polymorphisms (endothelial nitric oxide synthase(r)+heme oxygenase-1(r)): 8 patients (24.2%) compared with FFRp/iFRn type of discrepancy: 2 patients (5.9%), P=0.03. Conclusions:Predictors for FFRp/iFRn discrepancy were sex, age, and location in the right coronary artery. Predictors for FFRn/iFRp were hemoglobin level, smoking, and renal insufficiency. The risk type of polymorphism in endothelial nitric oxide synthase and heme oxygenase-1 genes was more frequently found in patients with FFRn/iFRp type of discrepancy.

Links

TN01000013, research and development project

Name: Personalizovaná medicína - diagnostika a terapie

Investor: Technology Agency of the Czech Republic, Personalized Medicine – Diagnostics and Therapy

Citovat

KOVARNIK, Tomas, Matsuo HITOSHI, Ales KRAL, Stepan JERABEK, David ZEMANEK, Yoshiaki KAWASE, Hiroyuki OMORI, Toru TANIGAKI, Jan PUDIL, Alexandra VODZINSKA, Marian BRANNY, Roman ŠTÍPAL, Petr KALA, Jan MROZEK, Martin PORZER, Tomas GREZL, Kamil NOVOBILSKY, Oscar MENDIZ, Karel KOPRIVA, Martin MATES, Martin CHVAL, Zhi CHEN, Pavel MARTASEK and Ales LINHART. Fractional Flow Reserve Versus Instantaneous Wave-Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study. Journal of the American Heart Association. Hoboken: Wiley-Blackwell, 2022, vol. 11, No 9, p. 1-17. ISSN 2047-9980. Available from: https://dx.doi.org/10.1161/JAHA.121.021490.

@article{2250029,
   author = {Kovarnik, Tomas and Hitoshi, Matsuo and Kral, Ales and Jerabek, Stepan and Zemanek, David and Kawase, Yoshiaki and Omori, Hiroyuki and Tanigaki, Toru and Pudil, Jan and Vodzinska, Alexandra and Branny, Marian and Štípal, Roman and Kala, Petr and Mrozek, Jan and Porzer, Martin and Grezl, Tomas and Novobilsky, Kamil and Mendiz, Oscar and Kopriva, Karel and Mates, Martin and Chval, Martin and Chen, Zhi and Martasek, Pavel and Linhart, Ales},
   article_location = {Hoboken},
   article_number = {9},
   doi = {http://dx.doi.org/10.1161/JAHA.121.021490},
   keywords = {coronary flow reserve; fractional flow reserve; instantaneous wave-free ratio},
   language = {eng},
   issn = {2047-9980},
   journal = {Journal of the American Heart Association},
   title = {Fractional Flow Reserve Versus Instantaneous Wave-Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study},
   url = {https://www.ahajournals.org/doi/10.1161/JAHA.121.021490},
   volume = {11},
   year = {2022}
}

TY  - JOUR
ID  - 2250029
AU  - Kovarnik, Tomas - Hitoshi, Matsuo - Kral, Ales - Jerabek, Stepan - Zemanek, David - Kawase, Yoshiaki - Omori, Hiroyuki - Tanigaki, Toru - Pudil, Jan - Vodzinska, Alexandra - Branny, Marian - Štípal, Roman - Kala, Petr - Mrozek, Jan - Porzer, Martin - Grezl, Tomas - Novobilsky, Kamil - Mendiz, Oscar - Kopriva, Karel - Mates, Martin - Chval, Martin - Chen, Zhi - Martasek, Pavel - Linhart, Ales
PY  - 2022
TI  - Fractional Flow Reserve Versus Instantaneous Wave-Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study
JF  - Journal of the American Heart Association
VL  - 11
IS  - 9
SP  - 1-17
EP  - 1-17
PB  - Wiley-Blackwell
SN  - 20479980
KW  - coronary flow reserve
KW  - fractional flow reserve
KW  - instantaneous wave-free ratio
UR  - https://www.ahajournals.org/doi/10.1161/JAHA.121.021490
N2  - Background:The FiGARO (FFR versus iFR in Assessment of Hemodynamic Lesion Significance, and an Explanation of Their Discrepancies) trial is a prospective registry searching for predictors of fractional flow reserve/instantaneous wave-free ratio (FFR/iFR) discrepancy. Methods and Results:FFR/iFR were analyzed using a Verrata wire, and coronary flow reserve was analyzed using a Combomap machine (both Philips-Volcano). The risk polymorphisms for endothelial nitric oxide synthase and for heme oxygenase-1 were analyzed. In total, 1884 FFR/iFR measurements from 1564 patients were included. The FFR/iFR discrepancy occurred in 393 measurements (20.9%): FFRp (positive)/iFRn (negative) type (264 lesions, 14.0%) and FFRn/iFRp (129 lesions, 6.8%) type. Coronary flow reserve was measured in 343 lesions, correlating better with iFR (R=0.56, P<0.0001) than FFR (R=0.36, P<0.0001). The coronary flow reserve value in FFRp/iFRn lesions (2.24 +/- 0.7) was significantly higher compared with both FFRp/iFRp (1.39 +/- 0.36), and FFRn/iFRn lesions (1.8 +/- 0.64, P<0.0001). Multivariable logistic regression analysis confirmed (1) sex, age, and lesion location in the right coronary artery as predictors for FFRp/iFRn discrepancy; and (2) hemoglobin level, smoking, and renal insufficiency as predictors for FFRn/iFRp discrepancy. The FFRn/iFRp type of discrepancy was significantly more frequent in patients with both risk types of polymorphisms (endothelial nitric oxide synthase(r)+heme oxygenase-1(r)): 8 patients (24.2%) compared with FFRp/iFRn type of discrepancy: 2 patients (5.9%), P=0.03. Conclusions:Predictors for FFRp/iFRn discrepancy were sex, age, and location in the right coronary artery. Predictors for FFRn/iFRp were hemoglobin level, smoking, and renal insufficiency. The risk type of polymorphism in endothelial nitric oxide synthase and heme oxygenase-1 genes was more frequently found in patients with FFRn/iFRp type of discrepancy.
ER  -

KOVARNIK, Tomas, Matsuo HITOSHI, Ales KRAL, Stepan JERABEK, David ZEMANEK, Yoshiaki KAWASE, Hiroyuki OMORI, Toru TANIGAKI, Jan PUDIL, Alexandra VODZINSKA, Marian BRANNY, Roman ŠTÍPAL, Petr KALA, Jan MROZEK, Martin PORZER, Tomas GREZL, Kamil NOVOBILSKY, Oscar MENDIZ, Karel KOPRIVA, Martin MATES, Martin CHVAL, Zhi CHEN, Pavel MARTASEK and Ales LINHART. Fractional Flow Reserve Versus Instantaneous Wave-Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study. \textit{Journal of the American Heart Association}. Hoboken: Wiley-Blackwell, 2022, vol.~11, No~9, p.~1-17. ISSN~2047-9980. Available from: https://dx.doi.org/10.1161/JAHA.121.021490.

Detailed Information on Publication Record