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Ikeda K, Kubo T, Murasawa T, Deguchi H, Takihara K, Nukariya M, Kuwahara A, Nakayama T, Kitamura M, Tezuka T, Takagi R, Ito R, Kazawa S, Iwasaki Y, Yamada S, Satomi K, Tanaka N. Diagnostic performance of pressure-bounded coronary flow reserve. Cardiovasc Interv Ther 2024; 39:164-172. [PMID: 38329574 DOI: 10.1007/s12928-024-00983-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/26/2023] [Indexed: 02/09/2024]
Abstract
Fluid dynamics studies have proposed that coronary flow reserve can be calculated from coronary artery pressure instead of coronary blood flow. We sought to investigate the diagnostic performance of pressure-bounded coronary flow reserve (pb-CFR) compared with CFR measured by conventional thermodilution method (CFRthermo) in the clinical setting. Pressure guidewire was used to measure CFRthermo and fractional flow reserve (FFR) in left anterior descending coronary artery in 62 patients with stable coronary artery disease. Pb-CFR was calculated only with resting distal coronary artery pressure (Pd), resting aortic pressure (Pa) and FFR. Pb-CFR was moderately correlated with CFRthermo (r = 0.54, P < 0.001). Pb-CFR showed a poor agreement with CFRthermo, presenting large values of mean difference and root mean square deviation (1.5 ± 1.4). Pb-CFR < 2.0 predicted CFRthermo < 2.0 with an accuracy of 79%, sensitivity of 83%, specificity of 78%, positive predictive value of 48%, negative predictive value of 95%. The discordance presenting CFRthermo < 2.0 and pb-CFR ≥ 2.0 was associated with diffuse disease (P < 0.001). The discordance presenting CFRthermo ≥ 2 and pb-CFR < 2 was associated with a high FFR (P = 0.002). Pb-CFR showed moderate correlation and poor agreement with CFRthermo. Pb-CFR might be reliable in excluding epicardial coronary artery disease and microcirculatory disorders.
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Affiliation(s)
- Kazumasa Ikeda
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan
| | - Takashi Kubo
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan.
| | - Takahide Murasawa
- Department of Clinical Engineering, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, Japan
| | - Haruyuki Deguchi
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan
| | - Kazuya Takihara
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan
| | - Masato Nukariya
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan
| | - Asuka Kuwahara
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan
| | - Tomoaki Nakayama
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan
| | - Miki Kitamura
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan
| | - Taiyo Tezuka
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan
| | - Ryu Takagi
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan
| | - Ryosuke Ito
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan
| | - Shuichiro Kazawa
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan
| | - Yoichi Iwasaki
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan
| | - Satoshi Yamada
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan
| | - Kazuhiro Satomi
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Nobuhiro Tanaka
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo, 193-0998, Japan
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