Journal article
Fractional Flow Reserve Versus Instantaneous Wave-Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study
Journal of the American Heart Association, Vol.11(9), pp.e021490-e021490
05/03/2022
DOI: 10.1161/JAHA.121.021490
PMCID: PMC9238629
PMID: 35502771
Abstract
Background The FiGARO (FFR versus iFR in Assessment of Hemodynamic Lesion Significance, and an Explanation of Their Discrepancies) trial is a prospective registry searching for predictors of fractional flow reserve/instantaneous wave-free ratio (FFR/iFR) discrepancy. Methods and Results FFR/iFR were analyzed using a Verrata wire, and coronary flow reserve was analyzed using a Combomap machine (both Philips-Volcano). The risk polymorphisms for endothelial nitric oxide synthase and for heme oxygenase-1 were analyzed. In total, 1884 FFR/iFR measurements from 1564 patients were included. The FFR/iFR discrepancy occurred in 393 measurements (20.9%): FFRp (positive)/iFRn (negative) type (264 lesions, 14.0%) and FFRn/iFRp (129 lesions, 6.8%) type. Coronary flow reserve was measured in 343 lesions, correlating better with iFR (R=0.56,
<0.0001) than FFR (R=0.36,
<0.0001). The coronary flow reserve value in FFRp/iFRn lesions (2.24±0.7) was significantly higher compared with both FFRp/iFRp (1.39±0.36), and FFRn/iFRn lesions (1.8±0.64,
<0.0001). Multivariable logistic regression analysis confirmed (1) sex, age, and lesion location in the right coronary artery as predictors for FFRp/iFRn discrepancy; and (2) hemoglobin level, smoking, and renal insufficiency as predictors for FFRn/iFRp discrepancy. The FFRn/iFRp type of discrepancy was significantly more frequent in patients with both risk types of polymorphisms (endothelial nitric oxide synthase
+heme oxygenase-1
): 8 patients (24.2%) compared with FFRp/iFRn type of discrepancy: 2 patients (5.9%),
=0.03. Conclusions Predictors for FFRp/iFRn discrepancy were sex, age, and location in the right coronary artery. Predictors for FFRn/iFRp were hemoglobin level, smoking, and renal insufficiency. The risk type of polymorphism in endothelial nitric oxide synthase and heme oxygenase-1 genes was more frequently found in patients with FFRn/iFRp type of discrepancy. Registration URL: https://clinicaltrials.gov; Unique identifier: NCT03033810.
Details
- Title: Subtitle
- Fractional Flow Reserve Versus Instantaneous Wave-Free Ratio in Assessment of Lesion Hemodynamic Significance and Explanation of their Discrepancies. International, Multicenter and Prospective Trial: The FiGARO Study
- Creators
- Tomas Kovarnik - General University Hospital in PragueMatsuo Hitoshi - Gifu Heart CenterAles Kral - Charles UniversityStepan Jerabek - General University Hospital in PragueDavid Zemanek - Charles UniversityYoshiaki Kawase - Gifu Heart CenterHiroyuki Omori - Gifu Heart CenterToru Tanigaki - Gifu Heart CenterJan Pudil - General University Hospital in PragueAlexandra Vodzinska - Nemocnice PodlesíMarian Branny - University Hospital OstravaRoman Stipal - Masaryk UniversityPetr Kala - Masaryk UniversityJan Mrozek - University Hospital OstravaMartin Porzer - University Hospital OstravaTomas Grezl - University Hospital OstravaKamil Novobilsky - University Hospital OstravaOscar Mendiz - Favaloro FoundationKarel Kopriva - Na Homolce HospitalMartin Mates - Na Homolce HospitalMartin Chval - Charles UniversityZhi Chen - University of IowaPavel Martasek - Charles UniversityAles Linhart - General University Hospital in PragueFiGARO trial investigators
- Resource Type
- Journal article
- Publication Details
- Journal of the American Heart Association, Vol.11(9), pp.e021490-e021490
- DOI
- 10.1161/JAHA.121.021490
- PMID
- 35502771
- PMCID
- PMC9238629
- ISSN
- 2047-9980
- eISSN
- 2047-9980
- Language
- English
- Date published
- 05/03/2022
- Academic Unit
- Electrical and Computer Engineering; The Iowa Institute for Biomedical Imaging
- Record Identifier
- 9984627289302771
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