Catheterization and Cardiovascular Interventions

Volume 95, Issue S1 pp. 624-632

CORONARY ARTERY DISEASE

Novel application of quantitative flow ratio for predicting microvascular dysfunction after ST-segment-elevation myocardial infarction

Xincheng Sheng MD,

Xincheng Sheng MD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Zhiqing Qiao MD, PhD,

Zhiqing Qiao MD, PhD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Heng Ge MD, PhD,

Heng Ge MD, PhD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Jiateng Sun MD, PhD,

Jiateng Sun MD, PhD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Jie He MD,

Jie He MD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Zheng Li MD,

Zheng Li MD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Song Ding MD, PhD,

Corresponding Author

Song Ding MD, PhD

[email protected]

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

Correspondence

Jun Pu and Song Ding, Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pu Jian Road, Shanghai 200127, China.

Email: [email protected] (J. P.) and [email protected] (S. D.)

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Jun Pu MD, PhD,

Corresponding Author

Jun Pu MD, PhD

[email protected]

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

Correspondence

Jun Pu and Song Ding, Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pu Jian Road, Shanghai 200127, China.

Email: [email protected] (J. P.) and [email protected] (S. D.)

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Xincheng Sheng MD,

Xincheng Sheng MD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Zhiqing Qiao MD, PhD,

Zhiqing Qiao MD, PhD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Heng Ge MD, PhD,

Heng Ge MD, PhD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Jiateng Sun MD, PhD,

Jiateng Sun MD, PhD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Jie He MD,

Jie He MD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Zheng Li MD,

Zheng Li MD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Song Ding MD, PhD,

Corresponding Author

Song Ding MD, PhD

[email protected]

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

Correspondence

Jun Pu and Song Ding, Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pu Jian Road, Shanghai 200127, China.

Email: [email protected] (J. P.) and [email protected] (S. D.)

Search for more papers by this author

Jun Pu MD, PhD,

Corresponding Author

Jun Pu MD, PhD

[email protected]

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

Correspondence

Jun Pu and Song Ding, Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pu Jian Road, Shanghai 200127, China.

Email: [email protected] (J. P.) and [email protected] (S. D.)

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First published: 08 January 2020

https://doi.org/10.1002/ccd.28718

Citations: 19

Xincheng Sheng and Zhiqing Qiao contributed equally to this work.

Funding information: National Key Research and Development Program of China, Grant/Award Numbers: 2016YFC1301203, SQ2018YFC130171; Shanghai ShenKang Hospital Development Center, Grant/Award Numbers: SHDC12019X12, 16CR3034A; Shanghai Jiao Tong University, Grant/Award Number: YG2015ZD04

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Abstract

Objectives

This study evaluated quantitative flow ratio (QFR) to predict microvascular dysfunction (MVD) in patients with ST-segment elevation myocardial infarction (STEMI).

Background

QFR is a novel approach for the rapid computation of fractional flow reserve based on three-dimensional quantitative coronary angiography. We hypothesized that QFR computation could be used to predict MVD after STEMI.

Methods

Indexes such as contrast-flow QFR (cQFR), fixed-flow QFR (fQFR), and hyperemic flow velocity (HFV) were calculated in 130 STEMI patients with culprit lesion with ≥50% diameter stenosis and TIMI flow grade 2/3 in the spontaneously recanalized culprit artery on initial angiography. MVD was defined as microvascular obstruction determined by contrast-enhanced cardiac magnetic resonance at a median of 5 days after percutaneous coronary intervention.

Results

Patients were divided into the MVD group (76/130, 58.5%) and non-MVD group (54/130, 41.5%). Patients with MVD had higher cQFR-fQFR value (0.080 ± 0.058 vs. 0.038 ± 0.039, p < .001) and lower modeled HFV (0.096 ± 0.044 vs. 0.144 ± 0.041 m/s, p < .001). Receiver operator characteristic curve analysis revealed that both the cQFR-fQFR value (area under the curve, AUC = 0.716, p < .001) and modeled HFV (AUC = 0.805, p < .001) had high specificity and positive predictive value to predict MVD. In multivariable logistic analysis, cQFR-fQFR was identified as an independent predictor of MVD (odds ratio = 9.800, p < .001).

Conclusions

This proof-of-concept study suggested that QFR computation may be a useful tool to predict MVD after STEMI (Trial Registration:NCT03780335).

CONFLICT OF INTEREST

There is no potential conflict of interest or relationships with industry.

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Citing Literature

Volume95, IssueS1

Supplement: CCI and CIT2020 ‐‐‐ A Special Year of the Special Issue

February 1, 2020

Pages 624-632

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Novel application of quantitative flow ratio for predicting microvascular dysfunction after ST-segment-elevation myocardial infarction

Abstract

Objectives

Background

Methods

Results

Conclusions

CONFLICT OF INTEREST

REFERENCES

Citing Literature

References

Information

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Novel application of quantitative flow ratio for predicting microvascular dysfunction after ST-segment-elevation myocardial infarction

Abstract

Objectives

Background

Methods

Results

Conclusions

CONFLICT OF INTEREST

REFERENCES

Citing Literature

References

Related

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