Performance of quantitative flow ratio in patients with aortic stenosis undergoing transcatheter aortic valve implantation

Martin Sejr-Hansen; Evald Høj Christiansen; Yousif Ahmad; Jeroen Vendrik; Jelmer Westra; Niels R Holm; Troels Thim; Henry Seligman; Kerry Hall; Sayan Sen; Christian Juhl Terkelsen; Ashkan Eftekhari

doi:10.1002/ccd.29518

Performance of quantitative flow ratio in patients with aortic stenosis undergoing transcatheter aortic valve implantation

Martin Sejr-Hansen^*, Evald Høj Christiansen, Yousif Ahmad, Jeroen Vendrik, Jelmer Westra, Niels R Holm, Troels Thim, Henry Seligman, Kerry Hall, Sayan Sen, Christian Juhl Terkelsen, Ashkan Eftekhari

^*Corresponding author af dette arbejde

Institut for Klinisk Medicin - Hjertesygdomme

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

Abstract

OBJECTIVES: This study aims to evaluate the diagnostic performance of quantitative flow ratio (QFR) pre transcatheter aortic valve implantation (TAVI) in patients with aortic valve stenosis (AS) and coronary artery disease (CAD). Post-TAVI fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) was used as reference.

BACKGROUND: CAD is prevalent in patients with AS, but the hemodynamics of AS confounds evaluation using pressure wire-based assessments. QFR might be less sensitive to the presence of AS thereby allowing for CAD evaluation before aortic valve replacement. Further, QFR does not require the use of pressure wire and therefore has the potential for reducing costs and complications related to insertion of a coronary pressure wire.

METHODS: The diagnostic performance of QFR in coronary angiograms from 28 patients undergoing TAVI was evaluated. In all patients, both FFR and iFR were measured pre- and immediately post-TAVI while QFR was measured pre-TAVI.

RESULTS: Using post-TAVI FFR and iFR as reference the diagnostic accuracy of pre-TAVI QFR were 83% (95%CI; 68-97) and 52% (95%CI; 30-74) p = .008, respectively.

CONCLUSIONS: Pre-TAVI QFR showed a good diagnostic performance using post-TAVI FFR as reference. QFR could become a wire-free, safe, and quick way of evaluating CAD in patients with severe AS undergoing TAVI.

Originalsprog	Engelsk
Tidsskrift	Catheterization and Cardiovascular Interventions
Vol/bind	99
Nummer	1
Sider (fra-til)	68-73
Antal sider	6
ISSN	1522-1946
DOI	https://doi.org/10.1002/ccd.29518
Status	Udgivet - jan. 2022

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Sejr-Hansen, M., Christiansen, E. H., Ahmad, Y., Vendrik, J., Westra, J., Holm, N. R., Thim, T., Seligman, H., Hall, K., Sen, S., Terkelsen, C. J., & Eftekhari, A. (2022). Performance of quantitative flow ratio in patients with aortic stenosis undergoing transcatheter aortic valve implantation. Catheterization and Cardiovascular Interventions, 99(1), 68-73. https://doi.org/10.1002/ccd.29518

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title = "Performance of quantitative flow ratio in patients with aortic stenosis undergoing transcatheter aortic valve implantation",

abstract = "OBJECTIVES: This study aims to evaluate the diagnostic performance of quantitative flow ratio (QFR) pre transcatheter aortic valve implantation (TAVI) in patients with aortic valve stenosis (AS) and coronary artery disease (CAD). Post-TAVI fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) was used as reference.BACKGROUND: CAD is prevalent in patients with AS, but the hemodynamics of AS confounds evaluation using pressure wire-based assessments. QFR might be less sensitive to the presence of AS thereby allowing for CAD evaluation before aortic valve replacement. Further, QFR does not require the use of pressure wire and therefore has the potential for reducing costs and complications related to insertion of a coronary pressure wire.METHODS: The diagnostic performance of QFR in coronary angiograms from 28 patients undergoing TAVI was evaluated. In all patients, both FFR and iFR were measured pre- and immediately post-TAVI while QFR was measured pre-TAVI.RESULTS: Using post-TAVI FFR and iFR as reference the diagnostic accuracy of pre-TAVI QFR were 83% (95%CI; 68-97) and 52% (95%CI; 30-74) p = .008, respectively.CONCLUSIONS: Pre-TAVI QFR showed a good diagnostic performance using post-TAVI FFR as reference. QFR could become a wire-free, safe, and quick way of evaluating CAD in patients with severe AS undergoing TAVI.",

keywords = "ANGIOGRAPHY, CORONARY, MANAGEMENT, RESERVE, aortic stenosis, coronary artery disease, coronary physiology, fractional flow reserve, free ratio, instantaneous wave&#8208, quantitative flow ratio",

author = "Martin Sejr-Hansen and Christiansen, {Evald H{\o}j} and Yousif Ahmad and Jeroen Vendrik and Jelmer Westra and Holm, {Niels R} and Troels Thim and Henry Seligman and Kerry Hall and Sayan Sen and Terkelsen, {Christian Juhl} and Ashkan Eftekhari",

note = "{\textcopyright} 2021 Wiley Periodicals LLC.",

year = "2022",

month = jan,

doi = "10.1002/ccd.29518",

language = "English",

volume = "99",

pages = "68--73",

journal = "Catheterization and Cardiovascular Interventions",

issn = "1522-1946",

publisher = "JohnWiley & Sons, Inc.",

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Sejr-Hansen, M , Christiansen, EH, Ahmad, Y, Vendrik, J, Westra, J , Holm, NR , Thim, T, Seligman, H, Hall, K, Sen, S, Terkelsen, CJ & Eftekhari, A 2022, 'Performance of quantitative flow ratio in patients with aortic stenosis undergoing transcatheter aortic valve implantation', Catheterization and Cardiovascular Interventions, bind 99, nr. 1, s. 68-73. https://doi.org/10.1002/ccd.29518

Performance of quantitative flow ratio in patients with aortic stenosis undergoing transcatheter aortic valve implantation. / Sejr-Hansen, Martin ; Christiansen, Evald Høj; Ahmad, Yousif et al.
I: Catheterization and Cardiovascular Interventions, Bind 99, Nr. 1, 01.2022, s. 68-73.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Performance of quantitative flow ratio in patients with aortic stenosis undergoing transcatheter aortic valve implantation

AU - Sejr-Hansen, Martin

AU - Christiansen, Evald Høj

AU - Ahmad, Yousif

AU - Vendrik, Jeroen

AU - Westra, Jelmer

AU - Holm, Niels R

AU - Thim, Troels

AU - Seligman, Henry

AU - Hall, Kerry

AU - Sen, Sayan

AU - Terkelsen, Christian Juhl

AU - Eftekhari, Ashkan

PY - 2022/1

Y1 - 2022/1

N2 - OBJECTIVES: This study aims to evaluate the diagnostic performance of quantitative flow ratio (QFR) pre transcatheter aortic valve implantation (TAVI) in patients with aortic valve stenosis (AS) and coronary artery disease (CAD). Post-TAVI fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) was used as reference.BACKGROUND: CAD is prevalent in patients with AS, but the hemodynamics of AS confounds evaluation using pressure wire-based assessments. QFR might be less sensitive to the presence of AS thereby allowing for CAD evaluation before aortic valve replacement. Further, QFR does not require the use of pressure wire and therefore has the potential for reducing costs and complications related to insertion of a coronary pressure wire.METHODS: The diagnostic performance of QFR in coronary angiograms from 28 patients undergoing TAVI was evaluated. In all patients, both FFR and iFR were measured pre- and immediately post-TAVI while QFR was measured pre-TAVI.RESULTS: Using post-TAVI FFR and iFR as reference the diagnostic accuracy of pre-TAVI QFR were 83% (95%CI; 68-97) and 52% (95%CI; 30-74) p = .008, respectively.CONCLUSIONS: Pre-TAVI QFR showed a good diagnostic performance using post-TAVI FFR as reference. QFR could become a wire-free, safe, and quick way of evaluating CAD in patients with severe AS undergoing TAVI.

AB - OBJECTIVES: This study aims to evaluate the diagnostic performance of quantitative flow ratio (QFR) pre transcatheter aortic valve implantation (TAVI) in patients with aortic valve stenosis (AS) and coronary artery disease (CAD). Post-TAVI fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) was used as reference.BACKGROUND: CAD is prevalent in patients with AS, but the hemodynamics of AS confounds evaluation using pressure wire-based assessments. QFR might be less sensitive to the presence of AS thereby allowing for CAD evaluation before aortic valve replacement. Further, QFR does not require the use of pressure wire and therefore has the potential for reducing costs and complications related to insertion of a coronary pressure wire.METHODS: The diagnostic performance of QFR in coronary angiograms from 28 patients undergoing TAVI was evaluated. In all patients, both FFR and iFR were measured pre- and immediately post-TAVI while QFR was measured pre-TAVI.RESULTS: Using post-TAVI FFR and iFR as reference the diagnostic accuracy of pre-TAVI QFR were 83% (95%CI; 68-97) and 52% (95%CI; 30-74) p = .008, respectively.CONCLUSIONS: Pre-TAVI QFR showed a good diagnostic performance using post-TAVI FFR as reference. QFR could become a wire-free, safe, and quick way of evaluating CAD in patients with severe AS undergoing TAVI.

KW - ANGIOGRAPHY

KW - CORONARY

KW - MANAGEMENT

KW - RESERVE

KW - aortic stenosis

KW - coronary artery disease

KW - coronary physiology

KW - fractional flow reserve

KW - free ratio

KW - instantaneous wave&#8208

KW - quantitative flow ratio

UR - http://www.scopus.com/inward/record.url?scp=85100382352&partnerID=8YFLogxK

U2 - 10.1002/ccd.29518

DO - 10.1002/ccd.29518

M3 - Journal article

C2 - 33533535

SN - 1522-1946

VL - 99

SP - 68

EP - 73

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

IS - 1

ER -

Performance of quantitative flow ratio in patients with aortic stenosis undergoing transcatheter aortic valve implantation

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