Impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL

Background The pressure-derived parameters fractional flow reserve (FFR) and the emerging instantaneous wave-free ratio (iFR) are the most widely applied invasive coronary physiology indices to guide revascularisation. However, approximately 15–20% of intermediate stenoses show discordant FFR and iF...
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Autor*in:	Stegehuis, Valérie [verfasserIn] Boerhout, Coen Kikuta, Yuetsu Cambero-Madera, Maribel van Royen, Niels Matsuo, Hitoshi Nakayama, Masafumi de Waard, Guus Knaapen, Paul Nijjer, Sukhjinder Petraco, Ricardo Siebes, Maria Davies, Justin Escaned, Javier van de Hoef, Tim Piek, Jan

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Instantaneous wave-free ratio Fractional flow reserve Coronary flow reserve Coronary flow capacity

Anmerkung:	© The Author(s) 2023

Übergeordnetes Werk:	Enthalten in: Netherlands heart journal - [S.l.] : PubMed Central, 2001, 31(2023), 11 vom: 18. Aug., Seite 434-443
Übergeordnetes Werk:	volume:31 ; year:2023 ; number:11 ; day:18 ; month:08 ; pages:434-443

Links:	Volltext

DOI / URN:	10.1007/s12471-023-01796-x

Katalog-ID:	SPR053537246

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245	1	0	\|a Impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL
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520			\|a Background The pressure-derived parameters fractional flow reserve (FFR) and the emerging instantaneous wave-free ratio (iFR) are the most widely applied invasive coronary physiology indices to guide revascularisation. However, approximately 15–20% of intermediate stenoses show discordant FFR and iFR, and therapeutical consensus is lacking. Aims We sought to associate hyperaemic stenosis resistance index, coronary flow reserve (CFR) and coronary flow capacity (CFC) to FFR/iFR discordance. Methods We assessed pressure and flow measurements of 647 intermediate lesions (593 patients) of two multi-centre international studies. Results FFR and iFR were discordant in 15% of all lesions (97 out of 647). FFR+/iFR− lesions had similar hyperaemic average peak velocity (hAPV), CFR and CFC as FFR−/iFR− lesions, whereas FFR−/iFR+ lesions had similar hAPV, CFR and CFC as FFR+/iFR+ lesions (p > 0.05 for all). FFR+/iFR− lesions were associated with lower baseline stenosis resistance, but not hyperaemic stenosis resistance, compared with FFR−/iFR+ lesions (p < 0.001). Conclusions Discordance with FFR+/iFR− is characterised by maximal flow values, CFR, and CFC patterns similar to FFR−/iFR− concordance that justifies conservative therapy. Discordance with FFR−/iFR+ on the other hand, is characterised by low flow values, CFR, and CFC patterns similar to iFR+/FFR+ concordance that may benefit from percutaneous coronary intervention.
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allfields	10.1007/s12471-023-01796-x doi (DE-627)SPR053537246 (SPR)s12471-023-01796-x-e DE-627 ger DE-627 rakwb eng Stegehuis, Valérie verfasserin aut Impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background The pressure-derived parameters fractional flow reserve (FFR) and the emerging instantaneous wave-free ratio (iFR) are the most widely applied invasive coronary physiology indices to guide revascularisation. However, approximately 15–20% of intermediate stenoses show discordant FFR and iFR, and therapeutical consensus is lacking. Aims We sought to associate hyperaemic stenosis resistance index, coronary flow reserve (CFR) and coronary flow capacity (CFC) to FFR/iFR discordance. Methods We assessed pressure and flow measurements of 647 intermediate lesions (593 patients) of two multi-centre international studies. Results FFR and iFR were discordant in 15% of all lesions (97 out of 647). FFR+/iFR− lesions had similar hyperaemic average peak velocity (hAPV), CFR and CFC as FFR−/iFR− lesions, whereas FFR−/iFR+ lesions had similar hAPV, CFR and CFC as FFR+/iFR+ lesions (p > 0.05 for all). FFR+/iFR− lesions were associated with lower baseline stenosis resistance, but not hyperaemic stenosis resistance, compared with FFR−/iFR+ lesions (p < 0.001). Conclusions Discordance with FFR+/iFR− is characterised by maximal flow values, CFR, and CFC patterns similar to FFR−/iFR− concordance that justifies conservative therapy. Discordance with FFR−/iFR+ on the other hand, is characterised by low flow values, CFR, and CFC patterns similar to iFR+/FFR+ concordance that may benefit from percutaneous coronary intervention. Instantaneous wave-free ratio (dpeaa)DE-He213 Fractional flow reserve (dpeaa)DE-He213 Coronary flow reserve (dpeaa)DE-He213 Coronary flow capacity (dpeaa)DE-He213 Boerhout, Coen aut Kikuta, Yuetsu aut Cambero-Madera, Maribel aut van Royen, Niels aut Matsuo, Hitoshi aut Nakayama, Masafumi aut de Waard, Guus aut Knaapen, Paul aut Nijjer, Sukhjinder aut Petraco, Ricardo aut Siebes, Maria aut Davies, Justin aut Escaned, Javier aut van de Hoef, Tim aut Piek, Jan aut Enthalten in Netherlands heart journal [S.l.] : PubMed Central, 2001 31(2023), 11 vom: 18. Aug., Seite 434-443 (DE-627)53467299X (DE-600)2365465-X 1876-6250 nnns volume:31 year:2023 number:11 day:18 month:08 pages:434-443 https://dx.doi.org/10.1007/s12471-023-01796-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 31 2023 11 18 08 434-443
spelling	10.1007/s12471-023-01796-x doi (DE-627)SPR053537246 (SPR)s12471-023-01796-x-e DE-627 ger DE-627 rakwb eng Stegehuis, Valérie verfasserin aut Impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background The pressure-derived parameters fractional flow reserve (FFR) and the emerging instantaneous wave-free ratio (iFR) are the most widely applied invasive coronary physiology indices to guide revascularisation. However, approximately 15–20% of intermediate stenoses show discordant FFR and iFR, and therapeutical consensus is lacking. Aims We sought to associate hyperaemic stenosis resistance index, coronary flow reserve (CFR) and coronary flow capacity (CFC) to FFR/iFR discordance. Methods We assessed pressure and flow measurements of 647 intermediate lesions (593 patients) of two multi-centre international studies. Results FFR and iFR were discordant in 15% of all lesions (97 out of 647). FFR+/iFR− lesions had similar hyperaemic average peak velocity (hAPV), CFR and CFC as FFR−/iFR− lesions, whereas FFR−/iFR+ lesions had similar hAPV, CFR and CFC as FFR+/iFR+ lesions (p > 0.05 for all). FFR+/iFR− lesions were associated with lower baseline stenosis resistance, but not hyperaemic stenosis resistance, compared with FFR−/iFR+ lesions (p < 0.001). Conclusions Discordance with FFR+/iFR− is characterised by maximal flow values, CFR, and CFC patterns similar to FFR−/iFR− concordance that justifies conservative therapy. Discordance with FFR−/iFR+ on the other hand, is characterised by low flow values, CFR, and CFC patterns similar to iFR+/FFR+ concordance that may benefit from percutaneous coronary intervention. Instantaneous wave-free ratio (dpeaa)DE-He213 Fractional flow reserve (dpeaa)DE-He213 Coronary flow reserve (dpeaa)DE-He213 Coronary flow capacity (dpeaa)DE-He213 Boerhout, Coen aut Kikuta, Yuetsu aut Cambero-Madera, Maribel aut van Royen, Niels aut Matsuo, Hitoshi aut Nakayama, Masafumi aut de Waard, Guus aut Knaapen, Paul aut Nijjer, Sukhjinder aut Petraco, Ricardo aut Siebes, Maria aut Davies, Justin aut Escaned, Javier aut van de Hoef, Tim aut Piek, Jan aut Enthalten in Netherlands heart journal [S.l.] : PubMed Central, 2001 31(2023), 11 vom: 18. Aug., Seite 434-443 (DE-627)53467299X (DE-600)2365465-X 1876-6250 nnns volume:31 year:2023 number:11 day:18 month:08 pages:434-443 https://dx.doi.org/10.1007/s12471-023-01796-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 31 2023 11 18 08 434-443
allfields_unstemmed	10.1007/s12471-023-01796-x doi (DE-627)SPR053537246 (SPR)s12471-023-01796-x-e DE-627 ger DE-627 rakwb eng Stegehuis, Valérie verfasserin aut Impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background The pressure-derived parameters fractional flow reserve (FFR) and the emerging instantaneous wave-free ratio (iFR) are the most widely applied invasive coronary physiology indices to guide revascularisation. However, approximately 15–20% of intermediate stenoses show discordant FFR and iFR, and therapeutical consensus is lacking. Aims We sought to associate hyperaemic stenosis resistance index, coronary flow reserve (CFR) and coronary flow capacity (CFC) to FFR/iFR discordance. Methods We assessed pressure and flow measurements of 647 intermediate lesions (593 patients) of two multi-centre international studies. Results FFR and iFR were discordant in 15% of all lesions (97 out of 647). FFR+/iFR− lesions had similar hyperaemic average peak velocity (hAPV), CFR and CFC as FFR−/iFR− lesions, whereas FFR−/iFR+ lesions had similar hAPV, CFR and CFC as FFR+/iFR+ lesions (p > 0.05 for all). FFR+/iFR− lesions were associated with lower baseline stenosis resistance, but not hyperaemic stenosis resistance, compared with FFR−/iFR+ lesions (p < 0.001). Conclusions Discordance with FFR+/iFR− is characterised by maximal flow values, CFR, and CFC patterns similar to FFR−/iFR− concordance that justifies conservative therapy. Discordance with FFR−/iFR+ on the other hand, is characterised by low flow values, CFR, and CFC patterns similar to iFR+/FFR+ concordance that may benefit from percutaneous coronary intervention. Instantaneous wave-free ratio (dpeaa)DE-He213 Fractional flow reserve (dpeaa)DE-He213 Coronary flow reserve (dpeaa)DE-He213 Coronary flow capacity (dpeaa)DE-He213 Boerhout, Coen aut Kikuta, Yuetsu aut Cambero-Madera, Maribel aut van Royen, Niels aut Matsuo, Hitoshi aut Nakayama, Masafumi aut de Waard, Guus aut Knaapen, Paul aut Nijjer, Sukhjinder aut Petraco, Ricardo aut Siebes, Maria aut Davies, Justin aut Escaned, Javier aut van de Hoef, Tim aut Piek, Jan aut Enthalten in Netherlands heart journal [S.l.] : PubMed Central, 2001 31(2023), 11 vom: 18. Aug., Seite 434-443 (DE-627)53467299X (DE-600)2365465-X 1876-6250 nnns volume:31 year:2023 number:11 day:18 month:08 pages:434-443 https://dx.doi.org/10.1007/s12471-023-01796-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 31 2023 11 18 08 434-443
allfieldsGer	10.1007/s12471-023-01796-x doi (DE-627)SPR053537246 (SPR)s12471-023-01796-x-e DE-627 ger DE-627 rakwb eng Stegehuis, Valérie verfasserin aut Impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background The pressure-derived parameters fractional flow reserve (FFR) and the emerging instantaneous wave-free ratio (iFR) are the most widely applied invasive coronary physiology indices to guide revascularisation. However, approximately 15–20% of intermediate stenoses show discordant FFR and iFR, and therapeutical consensus is lacking. Aims We sought to associate hyperaemic stenosis resistance index, coronary flow reserve (CFR) and coronary flow capacity (CFC) to FFR/iFR discordance. Methods We assessed pressure and flow measurements of 647 intermediate lesions (593 patients) of two multi-centre international studies. Results FFR and iFR were discordant in 15% of all lesions (97 out of 647). FFR+/iFR− lesions had similar hyperaemic average peak velocity (hAPV), CFR and CFC as FFR−/iFR− lesions, whereas FFR−/iFR+ lesions had similar hAPV, CFR and CFC as FFR+/iFR+ lesions (p > 0.05 for all). FFR+/iFR− lesions were associated with lower baseline stenosis resistance, but not hyperaemic stenosis resistance, compared with FFR−/iFR+ lesions (p < 0.001). Conclusions Discordance with FFR+/iFR− is characterised by maximal flow values, CFR, and CFC patterns similar to FFR−/iFR− concordance that justifies conservative therapy. Discordance with FFR−/iFR+ on the other hand, is characterised by low flow values, CFR, and CFC patterns similar to iFR+/FFR+ concordance that may benefit from percutaneous coronary intervention. Instantaneous wave-free ratio (dpeaa)DE-He213 Fractional flow reserve (dpeaa)DE-He213 Coronary flow reserve (dpeaa)DE-He213 Coronary flow capacity (dpeaa)DE-He213 Boerhout, Coen aut Kikuta, Yuetsu aut Cambero-Madera, Maribel aut van Royen, Niels aut Matsuo, Hitoshi aut Nakayama, Masafumi aut de Waard, Guus aut Knaapen, Paul aut Nijjer, Sukhjinder aut Petraco, Ricardo aut Siebes, Maria aut Davies, Justin aut Escaned, Javier aut van de Hoef, Tim aut Piek, Jan aut Enthalten in Netherlands heart journal [S.l.] : PubMed Central, 2001 31(2023), 11 vom: 18. Aug., Seite 434-443 (DE-627)53467299X (DE-600)2365465-X 1876-6250 nnns volume:31 year:2023 number:11 day:18 month:08 pages:434-443 https://dx.doi.org/10.1007/s12471-023-01796-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 31 2023 11 18 08 434-443
allfieldsSound	10.1007/s12471-023-01796-x doi (DE-627)SPR053537246 (SPR)s12471-023-01796-x-e DE-627 ger DE-627 rakwb eng Stegehuis, Valérie verfasserin aut Impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background The pressure-derived parameters fractional flow reserve (FFR) and the emerging instantaneous wave-free ratio (iFR) are the most widely applied invasive coronary physiology indices to guide revascularisation. However, approximately 15–20% of intermediate stenoses show discordant FFR and iFR, and therapeutical consensus is lacking. Aims We sought to associate hyperaemic stenosis resistance index, coronary flow reserve (CFR) and coronary flow capacity (CFC) to FFR/iFR discordance. Methods We assessed pressure and flow measurements of 647 intermediate lesions (593 patients) of two multi-centre international studies. Results FFR and iFR were discordant in 15% of all lesions (97 out of 647). FFR+/iFR− lesions had similar hyperaemic average peak velocity (hAPV), CFR and CFC as FFR−/iFR− lesions, whereas FFR−/iFR+ lesions had similar hAPV, CFR and CFC as FFR+/iFR+ lesions (p > 0.05 for all). FFR+/iFR− lesions were associated with lower baseline stenosis resistance, but not hyperaemic stenosis resistance, compared with FFR−/iFR+ lesions (p < 0.001). Conclusions Discordance with FFR+/iFR− is characterised by maximal flow values, CFR, and CFC patterns similar to FFR−/iFR− concordance that justifies conservative therapy. Discordance with FFR−/iFR+ on the other hand, is characterised by low flow values, CFR, and CFC patterns similar to iFR+/FFR+ concordance that may benefit from percutaneous coronary intervention. Instantaneous wave-free ratio (dpeaa)DE-He213 Fractional flow reserve (dpeaa)DE-He213 Coronary flow reserve (dpeaa)DE-He213 Coronary flow capacity (dpeaa)DE-He213 Boerhout, Coen aut Kikuta, Yuetsu aut Cambero-Madera, Maribel aut van Royen, Niels aut Matsuo, Hitoshi aut Nakayama, Masafumi aut de Waard, Guus aut Knaapen, Paul aut Nijjer, Sukhjinder aut Petraco, Ricardo aut Siebes, Maria aut Davies, Justin aut Escaned, Javier aut van de Hoef, Tim aut Piek, Jan aut Enthalten in Netherlands heart journal [S.l.] : PubMed Central, 2001 31(2023), 11 vom: 18. Aug., Seite 434-443 (DE-627)53467299X (DE-600)2365465-X 1876-6250 nnns volume:31 year:2023 number:11 day:18 month:08 pages:434-443 https://dx.doi.org/10.1007/s12471-023-01796-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 31 2023 11 18 08 434-443
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source	Enthalten in Netherlands heart journal 31(2023), 11 vom: 18. Aug., Seite 434-443 volume:31 year:2023 number:11 day:18 month:08 pages:434-443
sourceStr	Enthalten in Netherlands heart journal 31(2023), 11 vom: 18. Aug., Seite 434-443 volume:31 year:2023 number:11 day:18 month:08 pages:434-443
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topic_facet	Instantaneous wave-free ratio Fractional flow reserve Coronary flow reserve Coronary flow capacity
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authorswithroles_txt_mv	Stegehuis, Valérie @@aut@@ Boerhout, Coen @@aut@@ Kikuta, Yuetsu @@aut@@ Cambero-Madera, Maribel @@aut@@ van Royen, Niels @@aut@@ Matsuo, Hitoshi @@aut@@ Nakayama, Masafumi @@aut@@ de Waard, Guus @@aut@@ Knaapen, Paul @@aut@@ Nijjer, Sukhjinder @@aut@@ Petraco, Ricardo @@aut@@ Siebes, Maria @@aut@@ Davies, Justin @@aut@@ Escaned, Javier @@aut@@ van de Hoef, Tim @@aut@@ Piek, Jan @@aut@@
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However, approximately 15–20% of intermediate stenoses show discordant FFR and iFR, and therapeutical consensus is lacking. Aims We sought to associate hyperaemic stenosis resistance index, coronary flow reserve (CFR) and coronary flow capacity (CFC) to FFR/iFR discordance. Methods We assessed pressure and flow measurements of 647 intermediate lesions (593 patients) of two multi-centre international studies. Results FFR and iFR were discordant in 15% of all lesions (97 out of 647). FFR+/iFR− lesions had similar hyperaemic average peak velocity (hAPV), CFR and CFC as FFR−/iFR− lesions, whereas FFR−/iFR+ lesions had similar hAPV, CFR and CFC as FFR+/iFR+ lesions (p > 0.05 for all). FFR+/iFR− lesions were associated with lower baseline stenosis resistance, but not hyperaemic stenosis resistance, compared with FFR−/iFR+ lesions (p < 0.001). 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author	Stegehuis, Valérie
spellingShingle	Stegehuis, Valérie misc Instantaneous wave-free ratio misc Fractional flow reserve misc Coronary flow reserve misc Coronary flow capacity Impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL
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topic_title	Impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL Instantaneous wave-free ratio (dpeaa)DE-He213 Fractional flow reserve (dpeaa)DE-He213 Coronary flow reserve (dpeaa)DE-He213 Coronary flow capacity (dpeaa)DE-He213
topic	misc Instantaneous wave-free ratio misc Fractional flow reserve misc Coronary flow reserve misc Coronary flow capacity
topic_unstemmed	misc Instantaneous wave-free ratio misc Fractional flow reserve misc Coronary flow reserve misc Coronary flow capacity
topic_browse	misc Instantaneous wave-free ratio misc Fractional flow reserve misc Coronary flow reserve misc Coronary flow capacity
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title	Impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL
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title_full	Impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL
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author_browse	Stegehuis, Valérie Boerhout, Coen Kikuta, Yuetsu Cambero-Madera, Maribel van Royen, Niels Matsuo, Hitoshi Nakayama, Masafumi de Waard, Guus Knaapen, Paul Nijjer, Sukhjinder Petraco, Ricardo Siebes, Maria Davies, Justin Escaned, Javier van de Hoef, Tim Piek, Jan
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title_sort	impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of define-flow and ideal
title_auth	Impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL
abstract	Background The pressure-derived parameters fractional flow reserve (FFR) and the emerging instantaneous wave-free ratio (iFR) are the most widely applied invasive coronary physiology indices to guide revascularisation. However, approximately 15–20% of intermediate stenoses show discordant FFR and iFR, and therapeutical consensus is lacking. Aims We sought to associate hyperaemic stenosis resistance index, coronary flow reserve (CFR) and coronary flow capacity (CFC) to FFR/iFR discordance. Methods We assessed pressure and flow measurements of 647 intermediate lesions (593 patients) of two multi-centre international studies. Results FFR and iFR were discordant in 15% of all lesions (97 out of 647). FFR+/iFR− lesions had similar hyperaemic average peak velocity (hAPV), CFR and CFC as FFR−/iFR− lesions, whereas FFR−/iFR+ lesions had similar hAPV, CFR and CFC as FFR+/iFR+ lesions (p > 0.05 for all). FFR+/iFR− lesions were associated with lower baseline stenosis resistance, but not hyperaemic stenosis resistance, compared with FFR−/iFR+ lesions (p < 0.001). Conclusions Discordance with FFR+/iFR− is characterised by maximal flow values, CFR, and CFC patterns similar to FFR−/iFR− concordance that justifies conservative therapy. Discordance with FFR−/iFR+ on the other hand, is characterised by low flow values, CFR, and CFC patterns similar to iFR+/FFR+ concordance that may benefit from percutaneous coronary intervention. © The Author(s) 2023
abstractGer	Background The pressure-derived parameters fractional flow reserve (FFR) and the emerging instantaneous wave-free ratio (iFR) are the most widely applied invasive coronary physiology indices to guide revascularisation. However, approximately 15–20% of intermediate stenoses show discordant FFR and iFR, and therapeutical consensus is lacking. Aims We sought to associate hyperaemic stenosis resistance index, coronary flow reserve (CFR) and coronary flow capacity (CFC) to FFR/iFR discordance. Methods We assessed pressure and flow measurements of 647 intermediate lesions (593 patients) of two multi-centre international studies. Results FFR and iFR were discordant in 15% of all lesions (97 out of 647). FFR+/iFR− lesions had similar hyperaemic average peak velocity (hAPV), CFR and CFC as FFR−/iFR− lesions, whereas FFR−/iFR+ lesions had similar hAPV, CFR and CFC as FFR+/iFR+ lesions (p > 0.05 for all). FFR+/iFR− lesions were associated with lower baseline stenosis resistance, but not hyperaemic stenosis resistance, compared with FFR−/iFR+ lesions (p < 0.001). Conclusions Discordance with FFR+/iFR− is characterised by maximal flow values, CFR, and CFC patterns similar to FFR−/iFR− concordance that justifies conservative therapy. Discordance with FFR−/iFR+ on the other hand, is characterised by low flow values, CFR, and CFC patterns similar to iFR+/FFR+ concordance that may benefit from percutaneous coronary intervention. © The Author(s) 2023
abstract_unstemmed	Background The pressure-derived parameters fractional flow reserve (FFR) and the emerging instantaneous wave-free ratio (iFR) are the most widely applied invasive coronary physiology indices to guide revascularisation. However, approximately 15–20% of intermediate stenoses show discordant FFR and iFR, and therapeutical consensus is lacking. Aims We sought to associate hyperaemic stenosis resistance index, coronary flow reserve (CFR) and coronary flow capacity (CFC) to FFR/iFR discordance. Methods We assessed pressure and flow measurements of 647 intermediate lesions (593 patients) of two multi-centre international studies. Results FFR and iFR were discordant in 15% of all lesions (97 out of 647). FFR+/iFR− lesions had similar hyperaemic average peak velocity (hAPV), CFR and CFC as FFR−/iFR− lesions, whereas FFR−/iFR+ lesions had similar hAPV, CFR and CFC as FFR+/iFR+ lesions (p > 0.05 for all). FFR+/iFR− lesions were associated with lower baseline stenosis resistance, but not hyperaemic stenosis resistance, compared with FFR−/iFR+ lesions (p < 0.001). Conclusions Discordance with FFR+/iFR− is characterised by maximal flow values, CFR, and CFC patterns similar to FFR−/iFR− concordance that justifies conservative therapy. Discordance with FFR−/iFR+ on the other hand, is characterised by low flow values, CFR, and CFC patterns similar to iFR+/FFR+ concordance that may benefit from percutaneous coronary intervention. © The Author(s) 2023
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title_short	Impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL
url	https://dx.doi.org/10.1007/s12471-023-01796-x
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author2	Boerhout, Coen Kikuta, Yuetsu Cambero-Madera, Maribel van Royen, Niels Matsuo, Hitoshi Nakayama, Masafumi de Waard, Guus Knaapen, Paul Nijjer, Sukhjinder Petraco, Ricardo Siebes, Maria Davies, Justin Escaned, Javier van de Hoef, Tim Piek, Jan
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However, approximately 15–20% of intermediate stenoses show discordant FFR and iFR, and therapeutical consensus is lacking. Aims We sought to associate hyperaemic stenosis resistance index, coronary flow reserve (CFR) and coronary flow capacity (CFC) to FFR/iFR discordance. Methods We assessed pressure and flow measurements of 647 intermediate lesions (593 patients) of two multi-centre international studies. Results FFR and iFR were discordant in 15% of all lesions (97 out of 647). FFR+/iFR− lesions had similar hyperaemic average peak velocity (hAPV), CFR and CFC as FFR−/iFR− lesions, whereas FFR−/iFR+ lesions had similar hAPV, CFR and CFC as FFR+/iFR+ lesions (p > 0.05 for all). FFR+/iFR− lesions were associated with lower baseline stenosis resistance, but not hyperaemic stenosis resistance, compared with FFR−/iFR+ lesions (p < 0.001). Conclusions Discordance with FFR+/iFR− is characterised by maximal flow values, CFR, and CFC patterns similar to FFR−/iFR− concordance that justifies conservative therapy. 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Impact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL

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