Basal stenosis resistance index derived from simultaneous pressure and flow velocity measurements

Tim P van de Hoef; Ricardo Petraco; Martijn A van Lavieren; Sukhjinder Nijjer; Froukje Nolte; Sayan Sen; Mauro Echavarria-Pinto; José P S Henriques; Karel T Koch; Jan Baan; Robbert J de Winter; Maria Siebes; Jos A E Spaan; Jan G P Tijssen; Martijn Meuwissen; Javier Escaned; Justin E Davies; Jan J Piek

doi:10.4244/EIJV12I2A33

Basal stenosis resistance index derived from simultaneous pressure and flow velocity measurements

Tim P van de Hoef, Ricardo Petraco, Martijn A van Lavieren, Sukhjinder Nijjer, Froukje Nolte, Sayan Sen, Mauro Echavarria-Pinto, José P S Henriques, Karel T Koch, Jan Baan, Robbert J de Winter, Maria Siebes, Jos A E Spaan, Jan G P Tijssen, Martijn Meuwissen, Javier Escaned, Justin E Davies, Jan J Piek

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

AIMS: Vasodilator-free basal stenosis resistance (BSR) equals fractional flow reserve (FFR) accuracy for ischaemia-inducing stenoses. Nonetheless, basal haemodynamic variability may impair BSR accuracy compared with hyperaemic stenosis resistance (HSR). We evaluated the influence of basal haemodynamic variability, as encountered in practice, on BSR accuracy versus HSR when derived from simultaneous pressure and flow velocity measurements, and determined its diagnostic performance for HSR-defined significant stenoses.

METHODS AND RESULTS: Simultaneous coronary pressure and flow velocity were obtained in 131 stenoses. The impact of basal haemodynamic conditions on BSR was evaluated by means of their relationship with the relative difference between BSR and HSR. Diagnostic performance of BSR, FFR, iFR, and resting Pd/Pa was assessed by comparing the area under the curve (AUC), using HSR as reference standard. The relative difference between BSR and HSR was not associated with basal heart rate, aortic pressure or rate pressure product. Among all stenoses, as well as within the 0.6-0.9 FFR range, BSR AUC was significantly greater than resting Pd/Pa and iFR AUC; all other AUCs were equivalent.

CONCLUSIONS: With simultaneous pressure and flow velocity measurements, basal conditions do not systematically limit BSR accuracy compared with HSR. Consequently, diagnostic performance of BSR is equivalent to FFR, and closely approximates HSR.

Original language	English
Pages (from-to)	e199-207
Journal	EuroIntervention
Volume	12
Issue number	2
DOIs	https://doi.org/10.4244/EIJV12I2A33
Publication status	Published - 12 Jun 2016
Externally published	Yes

Keywords

Aged
Cardiac Catheterization/methods
Constriction, Pathologic/diagnosis
Coronary Stenosis/therapy
Female
Fractional Flow Reserve, Myocardial/physiology
Humans
Male
Middle Aged
Predictive Value of Tests
Vasodilator Agents/therapeutic use

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van de Hoef, T. P., Petraco, R., van Lavieren, M. A., Nijjer, S., Nolte, F., Sen, S., Echavarria-Pinto, M., Henriques, J. P. S., Koch, K. T., Baan, J., de Winter, R. J., Siebes, M., Spaan, J. A. E., Tijssen, J. G. P., Meuwissen, M., Escaned, J., Davies, J. E., & Piek, J. J. (2016). Basal stenosis resistance index derived from simultaneous pressure and flow velocity measurements. EuroIntervention, 12(2), e199-207. https://doi.org/10.4244/EIJV12I2A33

@article{5b36ae8c4dc74d91b062db1008fb67f4,

title = "Basal stenosis resistance index derived from simultaneous pressure and flow velocity measurements",

abstract = "AIMS: Vasodilator-free basal stenosis resistance (BSR) equals fractional flow reserve (FFR) accuracy for ischaemia-inducing stenoses. Nonetheless, basal haemodynamic variability may impair BSR accuracy compared with hyperaemic stenosis resistance (HSR). We evaluated the influence of basal haemodynamic variability, as encountered in practice, on BSR accuracy versus HSR when derived from simultaneous pressure and flow velocity measurements, and determined its diagnostic performance for HSR-defined significant stenoses.METHODS AND RESULTS: Simultaneous coronary pressure and flow velocity were obtained in 131 stenoses. The impact of basal haemodynamic conditions on BSR was evaluated by means of their relationship with the relative difference between BSR and HSR. Diagnostic performance of BSR, FFR, iFR, and resting Pd/Pa was assessed by comparing the area under the curve (AUC), using HSR as reference standard. The relative difference between BSR and HSR was not associated with basal heart rate, aortic pressure or rate pressure product. Among all stenoses, as well as within the 0.6-0.9 FFR range, BSR AUC was significantly greater than resting Pd/Pa and iFR AUC; all other AUCs were equivalent.CONCLUSIONS: With simultaneous pressure and flow velocity measurements, basal conditions do not systematically limit BSR accuracy compared with HSR. Consequently, diagnostic performance of BSR is equivalent to FFR, and closely approximates HSR.",

keywords = "Aged, Cardiac Catheterization/methods, Constriction, Pathologic/diagnosis, Coronary Stenosis/therapy, Female, Fractional Flow Reserve, Myocardial/physiology, Humans, Male, Middle Aged, Predictive Value of Tests, Vasodilator Agents/therapeutic use",

author = "\{van de Hoef\}, \{Tim P\} and Ricardo Petraco and \{van Lavieren\}, \{Martijn A\} and Sukhjinder Nijjer and Froukje Nolte and Sayan Sen and Mauro Echavarria-Pinto and Henriques, \{Jos{\'e} P S\} and Koch, \{Karel T\} and Jan Baan and \{de Winter\}, \{Robbert J\} and Maria Siebes and Spaan, \{Jos A E\} and Tijssen, \{Jan G P\} and Martijn Meuwissen and Javier Escaned and Davies, \{Justin E\} and Piek, \{Jan J\}",

year = "2016",

month = jun,

day = "12",

doi = "10.4244/EIJV12I2A33",

language = "English",

volume = "12",

pages = "e199--207",

journal = "EuroIntervention",

issn = "1774-024X",

publisher = "Europa Group",

number = "2",

}

van de Hoef, TP, Petraco, R, van Lavieren, MA, Nijjer, S, Nolte, F, Sen, S, Echavarria-Pinto, M, Henriques, JPS, Koch, KT, Baan, J, de Winter, RJ, Siebes, M, Spaan, JAE, Tijssen, JGP, Meuwissen, M, Escaned, J, Davies, JE & Piek, JJ 2016, 'Basal stenosis resistance index derived from simultaneous pressure and flow velocity measurements', EuroIntervention, vol. 12, no. 2, pp. e199-207. https://doi.org/10.4244/EIJV12I2A33

TY - JOUR

T1 - Basal stenosis resistance index derived from simultaneous pressure and flow velocity measurements

AU - van de Hoef, Tim P

AU - Petraco, Ricardo

AU - van Lavieren, Martijn A

AU - Nijjer, Sukhjinder

AU - Nolte, Froukje

AU - Sen, Sayan

AU - Echavarria-Pinto, Mauro

AU - Henriques, José P S

AU - Koch, Karel T

AU - Baan, Jan

AU - de Winter, Robbert J

AU - Siebes, Maria

AU - Spaan, Jos A E

AU - Tijssen, Jan G P

AU - Meuwissen, Martijn

AU - Escaned, Javier

AU - Davies, Justin E

AU - Piek, Jan J

PY - 2016/6/12

Y1 - 2016/6/12

N2 - AIMS: Vasodilator-free basal stenosis resistance (BSR) equals fractional flow reserve (FFR) accuracy for ischaemia-inducing stenoses. Nonetheless, basal haemodynamic variability may impair BSR accuracy compared with hyperaemic stenosis resistance (HSR). We evaluated the influence of basal haemodynamic variability, as encountered in practice, on BSR accuracy versus HSR when derived from simultaneous pressure and flow velocity measurements, and determined its diagnostic performance for HSR-defined significant stenoses.METHODS AND RESULTS: Simultaneous coronary pressure and flow velocity were obtained in 131 stenoses. The impact of basal haemodynamic conditions on BSR was evaluated by means of their relationship with the relative difference between BSR and HSR. Diagnostic performance of BSR, FFR, iFR, and resting Pd/Pa was assessed by comparing the area under the curve (AUC), using HSR as reference standard. The relative difference between BSR and HSR was not associated with basal heart rate, aortic pressure or rate pressure product. Among all stenoses, as well as within the 0.6-0.9 FFR range, BSR AUC was significantly greater than resting Pd/Pa and iFR AUC; all other AUCs were equivalent.CONCLUSIONS: With simultaneous pressure and flow velocity measurements, basal conditions do not systematically limit BSR accuracy compared with HSR. Consequently, diagnostic performance of BSR is equivalent to FFR, and closely approximates HSR.

AB - AIMS: Vasodilator-free basal stenosis resistance (BSR) equals fractional flow reserve (FFR) accuracy for ischaemia-inducing stenoses. Nonetheless, basal haemodynamic variability may impair BSR accuracy compared with hyperaemic stenosis resistance (HSR). We evaluated the influence of basal haemodynamic variability, as encountered in practice, on BSR accuracy versus HSR when derived from simultaneous pressure and flow velocity measurements, and determined its diagnostic performance for HSR-defined significant stenoses.METHODS AND RESULTS: Simultaneous coronary pressure and flow velocity were obtained in 131 stenoses. The impact of basal haemodynamic conditions on BSR was evaluated by means of their relationship with the relative difference between BSR and HSR. Diagnostic performance of BSR, FFR, iFR, and resting Pd/Pa was assessed by comparing the area under the curve (AUC), using HSR as reference standard. The relative difference between BSR and HSR was not associated with basal heart rate, aortic pressure or rate pressure product. Among all stenoses, as well as within the 0.6-0.9 FFR range, BSR AUC was significantly greater than resting Pd/Pa and iFR AUC; all other AUCs were equivalent.CONCLUSIONS: With simultaneous pressure and flow velocity measurements, basal conditions do not systematically limit BSR accuracy compared with HSR. Consequently, diagnostic performance of BSR is equivalent to FFR, and closely approximates HSR.

KW - Aged

KW - Cardiac Catheterization/methods

KW - Constriction, Pathologic/diagnosis

KW - Coronary Stenosis/therapy

KW - Female

KW - Fractional Flow Reserve, Myocardial/physiology

KW - Humans

KW - Male

KW - Middle Aged

KW - Predictive Value of Tests

KW - Vasodilator Agents/therapeutic use

U2 - 10.4244/EIJV12I2A33

DO - 10.4244/EIJV12I2A33

M3 - Article

C2 - 27290679

SN - 1774-024X

VL - 12

SP - e199-207

JO - EuroIntervention

JF - EuroIntervention

IS - 2

ER -

Basal stenosis resistance index derived from simultaneous pressure and flow velocity measurements

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Keywords

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