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Motorized fractional flow reserve pullback: Accuracy and reproducibility
Author(s) -
Sonck Jeroen,
Collet Carlos,
Mizukami Takuya,
Vandeloo Bert,
Argacha Jean F.,
Barbato Emanuele,
Andreini Daniele,
Bartorelli Antonio,
Cosyns Bernard,
De Bruyne Bernard
Publication year - 2020
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.28733
Subject(s) - fractional flow reserve , medicine , reproducibility , coronary artery disease , repeatability , pullback , cardiology , revascularization , mean difference , anatomical landmark , nuclear medicine , coronary angiography , mathematics , confidence interval , surgery , statistics , mathematical analysis , myocardial infarction
Objectives The present study aimed at determining the accuracy and reproducibility of motorized FFR pullbacks in patients with stable coronary artery disease. Background Fractional flow reserve (FFR) is recommended for decision making regarding myocardial revascularization. The distribution of epicardial resistance along coronary vessels can be assessed using FFR pullbacks. Methods Duplicated FFR pullbacks were acquired using a motorized device at a speed of 1 mm/s in intermediate coronary stenosis. In addition, a single FFR value was measured at an anatomical landmark. The agreement between FFR measurements was assessed using the Bland–Altman method, Pearson's correlation coefficient and area under the pullback curve (AUPC). Results In 20 vessels, 37,326 FFR values were obtained. The mean FFR from the pullbacks was 0.91 ± 0.08 whereas the mean FFR at the distal location was 0.85 ± 0.09. The mean difference between pullbacks was −0.002 (LOA −0.058 to 0.054). The difference in AUPC between the two FFR pullbacks was 2.1 ± 1.6%. At pre‐specified anatomical locations, the mean difference between the FFR derived from the pullback data and the measured FFR was 0 (LOA −0.040 to 0.039). The repeatability of the distal FFR measurement was high (bias −0.003, LOA −0.046 to 0.041). Conclusion A motorized FFR pullback was accurate to assess the distribution of epicardial resistance in patients with intermediate coronary artery disease. The reproducibility of the FFR pullback was high. Further studies are required to determine the potential usefulness of a hyperemic FFR pullback strategy for decision making and treatment planning.