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Journal of interventional cardiology
2023;2023 6461691.

Resting Full-Cycle Ratio versus Fractional Flow Reserve: A SWEDEHEART-Registry-Based Comparison of Two Physiological Indexes for Assessing Coronary Stenosis Severity.

Stephen Malmberg, J��rg Lauermann, Patric Karlstr��m, Dario Gulin, Neshro Barmano
Author Information
  1. Stephen Malmberg: Department of Health, Medicine and Caring Sciences, Link��ping University, Link��ping, Sweden. ORCID
  2. J��rg Lauermann: Department of Internal Medicine, Ryhov County Hospital, J��nk��ping, Sweden. ORCID
  3. Patric Karlstr��m: Department of Health, Medicine and Caring Sciences, Link��ping University, Link��ping, Sweden. ORCID
  4. Dario Gulin: Department of Internal Medicine, Ryhov County Hospital, J��nk��ping, Sweden. ORCID
  5. Neshro Barmano: Department of Health, Medicine and Caring Sciences, Link��ping University, Link��ping, Sweden. ORCID
PMID: 37427088 DOI: 10.1155/2023/6461691

Abstract

The adenosine-requiring physiological index fractional flow reserve (FFR) is the gold-standard method for determining the significance of intermediate lesions, while the resting full-cycle ratio (RFR) is a novel nonhyperaemic index without the need for adenosine administration. The aim of this study was to investigate the degree of concordance between RFR and FFR in indicating the need for revascularisation in patients with intermediate coronary lesions. This was a retrospective, registry-based study utilising data from the SWEDEHEART registry. Patients treated at Ryhov County Hospital in J��nk��ping, Sweden, between the 1 of January 2020 and the 30 of September 2021, were included. The degree of correlation and concordance between RFR and FFR was determined, both when used with a single cut-off (significant stenosis if RFR ���0.89) and with a hybrid approach (significant stenosis if RFR ���0.85, not significant if RFR ���0.94, and FFR measurement when RFR was in the grey zone 0.86-0.93). The study population consisted of 143 patients with 200 lesions. The overall correlation between FFR and RFR was significant (���=���0.715, ���=���0.511, ��� 0.01). A strong correlation was seen for lesions in the left anterior descending artery (LAD) and the left circumflex artery (LCX) (���=���0.748 and 0.742, respectively, both ��� 0.01), while the correlation in the right coronary artery (RCA) was moderate (���=���0.524, ��� 0.01). The overall concordance between FFR and RFR using a single cut-off was 79.0%. With a hybrid cut-off approach, the degree of concordance was 91%, with no need of adenosine in 50.5% of the lesions. In conclusion, there was a strong correlation and a high degree of concordance between FFR and RFR in determining the significance of a stenosis. The use of a hybrid approach could improve the identification of physiologically significant stenoses while minimising the use of adenosine.

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MeSH Term

Humans
Fractional Flow Reserve, Myocardial
Constriction, Pathologic
Retrospective Studies
Predictive Value of Tests
Cardiac Catheterization
Severity of Illness Index
Coronary Stenosis
Adenosine
Coronary Vessels
Registries
Coronary Angiography

Chemicals

Adenosine
Journal Article
Article has an altmetric score of 1

Word Cloud

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