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Relationship between coronary diastolic pressure indexes during the wave‐free period and a novel pressure‐derived index: Diastolic pressure ratio at the optimal point
Author(s) -
Nakao Fumiaki,
Ikeda Yasuhiro,
Oda Takamasa,
Ueda Tooru,
Ueyama Takeshi,
Fujii Takashi
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28019
Subject(s) - medicine , cardiology , diastole , blood pressure , pressure drop , ventricular pressure , receiver operating characteristic , aortic pressure , mechanics , physics
Objectives We aimed to determine the diastolic pressure ratio at the optimal point (DROP) using a simple measurement algorithm and to compare DROP with distal coronary‐to‐aortic pressure ratios during the wave‐free period (PR WFP ) and at the mid‐diastolic point (PR MD ). Methods Distal coronary and aortic pressures were measured from color pressure images of 440 beats in 48 patients with coronary stenoses. The DROP measurement point was 67% for one beat between the two rising points on the aortic pressure curve according to the distribution of the wave‐free period and the mid‐diastolic point. Results DROP correlated closely with PR WFP (r = 0.993, P < 0.0001) and PR MD (r = 0.997, P < 0.0001). The diagnostic efficiency was excellent (area under the receiver‐operating characteristic curve, 0.997) for both PR WFP ≤ 0.89 (specificity, 0.99; sensitivity, 0.96) and PR MD ≤ 0.89 (specificity, 0.95; sensitivity, 1.00). Conclusions A simple pressure‐derived physiological marker of coronary stenosis, DROP, might represent other diastolic pressure indexes with a numerical equivalency to the instantaneous wave‐free ratio. DROP can be measured automatically assuming that the rising points on the aortic pressure curve are detectable. However, further large‐scale clinical investigations are needed to determine whether DROP could contribute to the further generalization of physiology‐guided percutaneous coronary intervention.